In June 2015 Dr. Arthur Caplan opined on Medscape that physicians should be prepared to help patients in some way as they try to navigate the morass of medical information that is available on the Internet[i]. One oft quoted study from the Pew Research Institute (2013) suggests that over half of US adults have looked for health information on the internet and that up to 80% begin at a commercial search engine. What is less clear, however, is how many people get their attention waylaid by some other web based source of medical information, but it is likely a large number. Caplan suggests that at least several of these sources may have “Evil People” behind them.
There is generally some skepticism about information on the Internet, but this degree of skepticism is likely not as prevalent as would be desirable. In 2012 the State Farm Insurance Company sponsored a TV ad that began with the skit that ran:
“ ‘Where did you hear that?’; ‘The Internet’; ‘And you believed it?’; ‘Yeah, they can’t put anything on the internet that isn’t true.’; ‘Where did you hear that?’; ‘The internet’.”
If we are to be able to help our patients navigate the Internet, it would be helpful to determine what is easily available. There are several search engines, or search engine groups. One website posited at least 12 sites in addition to Google, which seems to be the de facto market leader, with upwards of 65% of searches beginning there.
In order to see what was available, I looked for health related information, in the top 4 commercially available search engines (Google, Bing (a Microsoft site), Yahoo, and Ask). I used the initial search term “Health Information Websites”. There are well over 180,000,000 active sites identified by each of the search engine sites (Yahoo claimed over 480,000,000 sites).
Some sites that may be helpful in finding reliable information include two on evaluating websites:
- https://nnlm.gov/outreach/consumer/evalsite.html accessed 7/6/15.
This one page site with an easy to read and follow process map on evaluating a webpage, is from the National Network of Libraries of Medicine, and may be among the most important sites available.
2. http://caphis.mlanet.org/consumer/index.html accessed 7/6/15
This is a website of the: Consumer and Patient Health Information Section of the Medical Library Association, Inc (https://www.mlanet.org/ ) , which has an interesting “User’s Guide” for finding and evaluating health information on the web (https://www.mlanet.org/resources/userguide.html)
They then have a list of “top 100 health websites you can trust”, which refers to NIH and other governmental websites as well as websites for many of the major disease specific professional organizations. This may be a good approach, but would likely be frustrating to a person who has a simple question to answer.
Evaluating Information on the Web:
In looking at a website to estimate reliability, most sources suggest looking at the site itself for its “professionalism”. Secondly one should ask whether there is an evident bias in the material – especially if the site is trying to sell something or asking for money. Thirdly, a searcher should ask whether the information that is being purported as real, is backed up with information from other sites. Finally, if the information on the site is supported by references or hyperlinks, it is more likely to be reliable. Evaluating these four characteristics: Professionalism, Bias, Uniformity through several sites, and provision of References should allow a person looking for health information to find reliable information upon which to make decisions.
Perhaps the easiest site to use and find reliable information is the Website of the National Institutes of Health: http://health.nih.gov/
My interpretation after spending time on the site is that it s well organized and has a robust search window, as well as directions to topics of interest, such as clinical trials, Medicare, and others. It was rated as in the top 3 of all the search engines.
Another Governmental Site that has links to many useful concepts is: https://www.nlm.nih.gov/medlineplus/
Other sites that were common to all the search engines were:
- CAPHIS (see above)
- Healthfinder.gov – Your Source for Reliable Health Information
- WebMD – Official Site
- Health.gov | Your Portal to Health Information from the US Department of Health and Human Services.
- Healthline: Medical Information & trusted Health Advice
There are many more, often included in the website of universities, insurance companies or other large healthcare providers, but if we send our patients, friends and other associates to these six sites, they will have a very good head start on their journey through the minefields of getting health information.
[i] Caplan, A.L.: Are Evil People Influencing Your Patients? /Medscape, Jun 24, 2015