Library Grand Rounds

Guiding your Patients to Reliable Health Information Resources: Hints for Clinicians

Anyone viewing health care information on the Web, whether patient or clinician, should learn to evaluate what they are reading. Two recent studies evaluated the accuracy and quality of information found on the Web:

• An article in the June 28, 1997, issue of the British Medical journal looked at 41 web pages which offered advice on managing fever in children at home. The authors found that only four sites offered complete and accurate information. (Impicciatore P, Pandolfini C, Casella N, Bonati M. Reliability of health information for the public on the world wide web: systematic survey of advice on managing fever in children at home. BMJ. 314(7098):1875, 1997 June 28.) Click here for full text*

• An article in the August 1, 1999, issue of Cancer analyzed 400 web pages found by searching for "Ewing's Sarcoma" in prominent search engines. Only 165 of these pages contained actual medical information and, of those, more than a third showed no evidence of peer review and 6% had clearly erroneous information. (Biermann JS. Golladay GJ. Greenfield ML. Baker LH. Evaluation of cancer information on the Internet. Cancer. 86(3):381-90, 1999 Aug 1.) Click here for full text*

Patients can probably find Web pages that will confirm any belief that they have about a treatment or condition. Biermann, et al., call the Internet "the great equalizer: experts, specialists, authorities, professionals, alternative therapy promoters, interested lay people, charlatans, and hucksters all may set up sites containing information regarding specific topics of interest."

Clinicians can help their patients by teaching them to ask questions about what they find on the Web: who produced the Web site, what are their credentials, are they trying to sell me something, do they offer references or evidence, how often is it updated? One should be very cautious if all of that is not clearly stated.

The Biomedical Libraries Web has a section on evaluating Web sites, both general sites and health-related ones. Several groups have been developing evaluation criteria for health information on the Web. The organization Health On the Net, or HON, has developed a set of principles and Web sites that subscribe to these principles can post the HON symbol on their pages as a sort of Good Housekeeping seal of approval. The Health Summit Working Group produced an excellent report under a government contract and came up with another good set of criteria. [link]

Since not all of us are fully qualified to judge the accuracy of the health care information we read on the Web, another approach is to start our search for health information at sites that we can trust to have done the evaluation for us and steer us to reliable information. That is what we have tried to provide on our Consumer Health Resources Web page.

* Full-text availability limited to Dartmouth College and DHMC-Lebanon users.

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