Finding Credible Health Information Online

Linda Pourmassina, MDThe Polyclinic

Seattle, WA

Background

Why is this topic important?Widely applicableCan be a source of anxiety.We are bombarded by confusing health

information.

OutlineWhere are we getting our health info?

Who looks for health info online?

How do you analyze a website for credibility?

What are some good websites for health information?

Where do most people look?

WebMD

Question/answer sites

Google

Who is feeding us health info?Our own doctors

Who is feeding us health info?Our own doctors (drop in the bucket)

Who is feeding us health info?Our own doctors (drop in the bucket)Radio/TVMagazinesNews websitesSocial mediaFriends/RelativesTV doctorsCelebrities

Who looks for health info online?59% of US adults (80% of internet users)

66% search for info about specific disease/medical problem

Women>men

Caregivers

http://pewinternet.org/Commentary/2011/November/Pew-Internet-Health.aspx

updated 3/1/2012

Who Looks for health info online?

“Eight in ten internet users look online for health information, making it the third most popular online activity”

From www.pewinternet.org

Who runs the website?

.gov (government-sponsored)

.edu (educational institution)

.org (noncommercial organization)

.com (commercial organization)

Who is doing the writing?“About Us”

Who is doing the writing?“About Us”Author credentials

Background, education, researchAssociated with an institution or organization?

If so, look up the institution to verify whether it’s legitimate

Contact infoIdeally, easy to find

Overview of the website/pageA “critical” first impression

Sloppy?

Spelling errors?

Poor grammar?

Overview of website/page

ADVERTISEMENTS

Are they clearly marked?

Reputable organizations make the distinction between written content and advertising clear.

Overview of page/website

If ads are not clearly marked, the site’s creators may be more interested in sales than providing you with accurate health info.

Analyzing contentWatch out for buzzwords/superlatives

Analyzing contentWatch out for buzzwords/superlatives

BREAKTHROUGH!!

Analyzing content Watch out for buzzwords/superlatives

BREAKTHROUGH!!

MIRACULOUS!!

Analyzing content Watch out for buzzwords/superlatives

BREAKTHROUGH!!

MIRACULOUS!!

BESTSELLING!!

Analyzing content Watch out for buzzwords/superlatives

BREAKTHROUGH!!MIRACULOUS!!BESTSELLING!!

Words generally used to try to convince the reader. Exclamation points and all caps are generally not

found in more writing.

Analyzing content

Is the information oversimplified?Is it well-balanced?

- pros and cons mentioned?

The clinical practice of medicine involves a lot of “ifs,” “ands,” and “buts.”

The media and press tend to oversimplify to retain viewership.

A Closer Look at Content (Fictional Example)

“A recent study shows that drinking grape juice reduces asthma attacks by 50 per cent”

Can you point out the potential problems of a statement like this?

A Closer Look at Content (Fictional Example)“A recent study shows that drinking grape juice

reduces asthma attacks by 50 per cent”

What does “recent” mean?Is the study referenced anywhere?

Hyperlinked?Is this a case of the “telephone game?”

A Closer Look at Content (Fictional Example)

“A recent study shows that drinking grape juice reduces asthma attacks by 50 per cent”

What does “50 per cent” mean? What is the sample size?

A Closer Look at Content (Fictional Example)“A recent study shows that drinking grape juice

reduces asthma attacks by 50 per cent”

Is there a corresponding advertisement?Or is the website produced by the America’s

Grape Growers Association (fictional group)?

Timing References to studies

mention of date or easy link to original article orbibliography

How often is the site updated?

Symptom Searches and Self-diagnosisWebMDGoogleMayo Clinic

scary stuff anxiety-provoking

Symptom Searches and Self-diagnosis

It’s OK if you looked something up on the web.

If you’re worried about a particular diagnosis, go ahead and tell your doc.

Symptom Searches and Self-diagnosis

BUT remember, that your doctor will give you the best possible diagnosis based on your story and his/her examination of you.

Other mediaJournalism

Health reporting is often in the hands of people who are not well-trained to critically appraise studies/journal articles. Omit limitations of studies.

“Fear-mongering”/sensationalism attracts viewers.

Sometimes do not fact checkTV doctors

Keep in mind: they work for TV stations who, in turn, care about viewership.

Other media (cont.)• Social media

Have to follow the “right people” to get the best quality health info

Where does your primary care doctor fit in all this?

He/she asks the right questionsIntegrates and individualizesUnbiasedHas your interest at heart

Recommended health websites

MedlinePlus

“MedlinePlus is the National Institutes of Health's Web site for patients and their families and friends. Produced by the National Library of Medicine, it brings you information about diseases, conditions, and wellness issues in language you can understand. MedlinePlus offers reliable, up-to-date health information, anytime, anywhere, for free.”

CDC.gov

“CDC Mission: Collaborating to create the expertise, information, and tools that people and communities need to protect their health – through health promotion, prevention of disease, injury and disability, and preparedness for new health threats.”

Cancer.gov

“The National Cancer Institute coordinates the National Cancer Program, which conducts and supports research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer, rehabilitation from cancer, and the continuing care of cancer patients and the families of cancer patients”

MayoClinic.com

Non-profit medical practice and medical research group

FamilyDoctor.org

“The mission of FamilyDoctor.org is to provide scientifically accurate information from a family medicine perspective to improve the health of all individuals and communities”

KingCounty.gov

Health section

Local information

From disease outbreaks to information on cancer screening to healthy recipes

HealthNewsReview.org

“What is HealthNewsReview.org?HealthNewsReview.org is a website dedicated to:Improving the accuracy of news stories about medical treatments, tests, products and procedures.Helping consumers evaluate the evidence for and against new ideas in health care.We support and encourage the ABCs of health journalism.-Accuracy-Balance-Completeness”

Can “.edu” be trusted?“Academic Medical Centers Often Guilty of

Research Hype”Wall Street Journal Blogs 5/4/2009

“Press Releases by Academic Medical Centers: Not So Academic”“Conclusion: Press releases from academic medical centers often promote research that has uncertain relevance to human health and do not provide key facts or acknowledge important limitations.”

Woloshin, S, et al. Annals of Internal Medicine May 5, 2009 vol. 150 no. 9 613-618

ConclusionEvaluate for the following:

Who is responsible for the content? Are advertisements clearly marked? Is the information well-balanced? (Pros/cons) Is the content clearly dated? Are there timely updates?

Be careful: Of sites that have advertising for their own products Of web content that is based on personal experience and opinion

Avoid: Superlatives, all caps, exclamation points Sites where advertising is “sneaky.” Sites that want your personal health information

ConclusionTake breaking news in health with a grain of

salt.There are very few encyclopedic-level

authorities when it comes to health information online.

Partner with a doctor you trust. Have a primary care doctor.

The good news: we are already seeing a movement towards the promotion of better health information online.

THANK YOU.