Untangling the Web of On-line Health Information

Written by: Katie Leboeuf, M.A. — CIGNA Behavioral Health

The Internet — just a few short years ago it was something many might have thought could only exist in science fiction movies. Now, as it has become a reality and a part of our everyday lives, many might question how they ever lived without it. The novelty of the World Wide Web may be wearing off somewhat, but the majority of Americans — nearly 150 million to be exact — are now online, and two million more are getting online every month, according to data from the U.S. Department of Commerce. Among the fastest growing segments are the young and the old; with the U.S. Department of Commerce reporting that 75% of 14-17 year-olds, 72.5% of 18-34 year-olds, and 22% of Americans over the age of 65 are now online. Further, 88% of Americans say the Internet plays a major role in their life (Rainie & Packel, 2001).

So what do all these numbers mean to our everyday lives? They mean a changing environment, an evolution of how Americas access information. People are no longer just accessing the Internet for hobby or pleasure; instead they have turned to the information superhighway for more serious activities such as exploring health and medical options. In all, about 60 million Americans are basing critical decisions about health and wellness using information gathered online, making trust and credibility on the Web increasingly important. The Internet opens the door to medical advice on a countless number of topics. While this 24-hour access to information is convenient, web surfers must guard against false, tainted or misleading data. Web sites are not always edited with the same care as print publications. As a result, researchers and consumers must critically evaluate the authority of a site's authors and the information it provides.

To date, there is no government agency or other authority that screens and/or controls the information posted to the World Wide Web. While the Web encourages the open exchange of ideas, we cannot always be assured how valid or reliable these ideas really are, or even if the source of the information is dependable. This means that web-users must carefully evaluate the information they find because the quality of the information is variable. Luckily, the Web can be "self-correcting" — because of the convenience of the Web it is just as easy to find accurate information as it is to find inaccurate information! Only when users compare the evidence from a number of Websites can they begin making informed decisions.

CIGNA Behavioral Health understands that often it is difficult to seek answers on a face-to-face level; some people may feel more comfortable accessing information in the privacy of their own homes without fear of judgment, labels, or scrutiny. On-line medical or mental health advice is never a replacement for a personalized relationship with a doctor or other health professional. However, the Web can become a tool, when properly handled, that can offer a person credible resources. Hopefully, it can also begin offering hope and courage for some to begin achieving wellness through the proper channels.

Some basic tips for beginning your on-line medical information search:

• Start your information search at a safe place. Rely on large, peer reviewed directories of health resources. Peer reviewed information lets you know that a doctor or other health professional has reviewed the information presented by another doctor or health professional.
• Read reviews of web sites to determine their value and accuracy of information.
• When you must search, use a search engine that specifically identifies medical web sites. (This can be done simply, by running searches under key words such as "medical search engine").
• Be especially cautious of the information you find. If you have conditions that are difficult to treat or can have a terminal outcome — seek the advise of your doctor before making any adjustments to your care or treatment plan. Remember if a treatment sounds too good to be true, it probably is!
• Never follow advice without first consulting a health professional such as your doctor, pharmacist, physician assistant, mental health provider, or nurse practitioner.
• Use an online guide to evaluating web pages. (You can find sites that offer tools to evaluate the quality of various web pages offering similar information).

Safe Starting Points:

• Healthfinder – http://www.healthfinder.gov
• Familydoctor.org from the American Academy of Family Physicians — http://www.familydoctor.org
• NLM's MEDLINEplus – http://www.medlineplus.gov
• WebMDHealth – http://www.webmd.com

The Denison Memorial Medical Library (Fox, 2004) offers a helpful acronym (DOCTOr) to further assist you in deciphering which websites might be reliable and which ones you should probably avoid. They suggest using the acronym DOCTOr to remember the key categories to evaluate when visiting on-line medical websites:

• Design — the aesthetics and ease of movement within the site. Is the site free of typographical or spelling errors? Is the site easy to use? Is the page layout organized and logical?
• Other — cost of use, is the site rated or reviewed by a reliable resource? If so, this information should be clearly posted for you to see on the homepage.
• Content — the depth and quality of information, its purpose and audience. If medical information or advice is given, is a disclaimer statement evident? Are side effects, complications, or drug interactions of a treatment discussed? Are outcomes or other claims based on scientific evidence or anecdotal testimonials (personal stories)? Do the treatments or interventions suggested conform to the recommendations of the best medical evidence? Is the information valuable or unique? Can the information be verified by another source (printed, newsgroup communication, another web page, medical professional)?
• Technical — the technology requirements of the site, the effectiveness of the technology used. Does the page state what technology or plug-ins are needed? Are links to sites that provide the plug-ins provided? Does the page require technology that can not be used on your computer? Is the page reliable? Do the links work? Is communication with the site secure?
• Origin — the author and sponsor of the site, their qualifications for presenting the information, the date of the information (this information often contained at the header or footer of the page). Who is the author of the page? What are the author's credentials or qualifications for writing on the subject of the page? Can the author be contacted via a e-mail link? Who is sponsoring the page? Is the information timeless? Or is the page regularly updated?

Any tool that can empower people to embrace their health and subsequent care is a tool worth utilizing, yet it should again be emphasized just how important it is that the users of the Web remain skeptical and cautious. Never alter your treatment or care without first seeking the advice of your treating physician. Always verify new information you find on-line with your treatment team. Most doctors will be happy to discuss options or new research, but this can only happen if you are honest and open about the materials/answers you are seeking. The Internet has changed our lives, opened doors to options not previously available, but at the end of the day, nothing can replace the healing power of personal contact.

Resources:

Fox, L. (2004). Evaluating medical information on the World Wide Web. Retrieved November 19, 2004 from the Denison Memorial Library.
Website: http://denison.uchsc.edu/education/eval.html

Rainie, L. & Packel, D. (2001). More online, doing more. Retrieved November 16, 2004 from The Pew Internet & American Life Project (Washington, DC).
Website: http://www.pewinternet.org

Any references in this material to other organizations or companies, including their Internet Websites, is not an endorsement or warranty of services, information or products provided by those organizations or companies.