Improving the Quality of Health Information on the Internet

Abstract

The Internet Healthcare Coalition (IHC), a nonprofit organization, believes it is possible to improve the quality of health information on the Internet without imposing new regulations and laws that limit the freedom of information providers or consumers. This article traces the history of the grass-roots development of the IHC beginning with an October 1996 FDA-sponsored public meeting. An online call to action led to the creation of the MEDWEB-MASTERS-L e-mail discussion group where important issues were debated and a community of interest developed. Subscribers felt it was important to meet in person during June 1997. At that time, it was resolved to create a coalition of health professionals, patients, industry, publishers, and Web developers with a common goal of promoting improved Internet health resources through education and self-regulation. The IHC is currently involved with efforts to help consumers and governments control health fraud on the Internet without destroying the Internet's ability to provide useful and legitimate health information. The Coalition plans to be an educational resource to support many independent efforts by members to improve the quality of health information on the Internet. In October 1998, it plans to hold its first annual meeting.     

Health Information for Gay Men on the Internet

Summary

The groundbreaking publication in April 2001 of the Healthy People 2010 Companion Document for Lesbian, Gay, Bisexual and Transgender Health supplement to the nation's Healthy People 2010 prevention agenda marked a crucial milestone for gay men, as well as other sexual minorities in the United States. Based on work done by the Gay and Lesbian Medical Association and scholars at Columbia University, this policy document outlined the most pressing health concerns for Lesbian, Gay, Bisexual and Transgender (LGBT) people. This article identifies those health concerns specific to gay men, and provides a review of highly select Web resources targeting this population.     

互联网联合预康复护理模式在冠心病合并心绞痛患者中的应用价值

目的 探讨互联网联合预康复护理模式在冠心病(CHD)合并心绞痛患者中的应用价值.方法 选择我院收治的110例CHD合并心绞痛患者,随机分为观察组(互联网联合预康复护理模式)与对照组(常规护理).比较两组的心绞痛发作状态及生活质量.结果 干预后,观察组的SAQ各维度评分、SF-36量表各维度评分均高于对照组(P<0.05...     

Information Resources for Men with Cancer

Summary

Finding accurate information on the Internet can be overwhelming and frustrating, for novice and sophisticated computer users alike. A search for cancer information can turn up thousands of Web sites, not all of which are reliable or well organized. The goal of this article is to point computer users to an array of credible Web sites for cancers that frequently affect men. According to the American Cancer Society, more than 1.2 million Americans will be diagnosed with cancer this year, over 600,000 of them men.¹ United States men have about a 1 in 2 lifetime risk of developing cancer compared with a 1 in 3 risk for women.¹ Cancer is the second leading cause of death in the United States.¹ The Web sites selected address the cancers that occur most frequently and have the highest death rates among men in the United States.     

MedlinePlus Goes Local in NC

ABSTRACT

NC Health Info is a collection of online North Carolina-based health services Web sites that links seamlessly with health information on MedlinePlus, the National Library of Medicine's consumer health information Web site. NC Health Info is the result of a pilot study to define the components involved in creating such a system, and serves as a model to be used by other states wishing to connect their own collections of health services with MedlinePlus. This paper addresses the seven major challenges faced during development and the tactics used to overcome those challenges.     

几种冠心病诊断技术在高校保健中的应用

介绍了几种冠心病的诊断技术,分析并比较了它们在冠心病诊断中的作用.在有症状患者的不典型静息ECG中,应对其T波(如TV1＞TV5),ST段变化、PtfV1、双峰P波等作用仔细比较分析,以免漏诊;结合运动ECG、HFECG、心电图Nehb导联、头胸导联ECG、DCG等多种手段综合分析.以期给高校医疗保健工作者提供参考.     

几种冠心病诊断技术在高校保健中的应用

介绍了几种冠心病的诊断技术,分析并比较了它们在冠心病诊断中的作用。在有症状患者的不典型静息ECG中,应对其T波(如TV1>TV5),ST段变化、PtfV1、双峰P波等作用仔细比较分析,以免漏诊;结合运动ECG、HFECG、心电图Nehb导联、头胸导联ECG、DCG等多种手段综合分析。以期给高校医疗保健工作者提供参考。     

Hormones and Cardiovascular Disease in Older Men

Older men have lower circulating testosterone (T) and insulin-like growth factor-I (IGF-I) but higher levels of thyrotrophin (TSH) compared with younger men, and exhibit poorer health. Whether age-associated differences in hormone levels are causally related to cardiovascular disease, or are biomarkers reflecting accumulated ill-health remains under debate. Lower T levels are associated with aortic, peripheral vascular, and cardiovascular disease in middle-aged and older men. In some but not all studies, lower levels of T predict increased incidence of cardiovascular events and mortality. Recently, dihydrotestosterone (DHT) has also been identified as a predictor for peripheral vascular and ischemic heart disease. Small scale randomized clinical trials (RCTs) of T supplementation suggest a protective effect against myocardial ischemia in men with coronary artery disease. There have been no RCTs with the prespecified outcomes of cardiovascular events or mortality. One RCT of T in older men with mobility limitations was stopped due to an excess of cardiovascular adverse events in men receiving T, but other RCTs have not raised similar concerns. Observational studies of testosterone supplementation have reported contrasting results. Levels of IGF-I and its binding proteins 1 and 3 have been variably associated with mortality in some but not all studies, and RCTs of interventions to modulate IGF-I levels are either lacking or lacking in power to examine outcomes of cardiovascular events or mortality. Subclinical hyper- and hypothyroidism predict poorer outcomes, and emerging data implicate higher levels of free thyroxine with other outcomes such as dementia and mortality in older men. However, RCTs that manipulate free thyroxine levels within the normal range are lacking and would be challenging to perform. Further research is needed to clarify the role of these hormones as predictors of cardiovascular outcomes in aging men, and to test whether interventions that modulate levels of T, DHT, IGF-I or free thyroxine would reduce cardiovascular morbidity and mortality.     

针对性综合健康管理对冠心病患者的应用效果

目的 探讨针对性综合健康管理对冠心病患者的应用效果.方法 将160例冠心病患者随机分为观察组(针对性综合健康管理)与对照组(常规健康教育).比较两组的健康行为能力及生活质量.结果 干预后,两组的运动、健康责任、营养、心理安适评分升高,且观察组的运动、健康责任、营养、心理安适评分高于对照组(P<0.05).观察组的FBG...     

Finding Information About Men's Health on the Internet

Summary

It's a well-known fact that men are less likely than women to seek health care. Men tend to wait as long as possible to see a doctor about a health problem, making early diagnosis of a disease difficult if not impossible. When one looks at the statistics related to men's health, the apparent aversion to seeking health care is disconcerting. Given the fact that men seem to be more private about their illnesses, the Internet provides an excellent place for them to seek health care information. A search of “men's health” finds an overwhelming number of sites on the Internet. This article provides a highly selected list of Web sites intended as a starting place for finding information about men's health on the Internet.     

Breast Cancer Internet Information

Abstract

Breast cancer is the most common cancer among women in North America and Europe. Every woman is at risk. The two most important risk factors are being female and getting older. The earlier breast cancer is found, the more likely it can be cured. This article describes Web sites that provide information about prevention, risk factors, diagnosis, treatment, and coping with breast cancer.     

Internet access for delivery of health information to South Australians older than 50

OBJECTIVE: An exploratory study to determine the proportion of people aged 50-76 years who have Internet access, the location of this access, predictive characteristics of such access, and preparedness to receive unsolicited health information through this medium. METHODS: A random sample of 1,000 South Australians was identified from the Australian Electoral Commission roll and contacted by telephone in 2006. They were invited to answer questions about their access to the Internet and attitude towards receiving unsolicited health information via the Internet. RESULTS: Of those contacted, 41% provided information. Of this group, 59% indicated that they had Internet access, mostly at home. Men were more likely than women to have home access (p<0.05). Higher educational achievement, higher economic status and younger age were all significantly associated with access. Of those who had access, 65% would be willing to receive health information through the Internet. CONCLUSIONS: More than half the population older than 50 years has access to the Internet at some location, and there is a general acceptance of the possibility of receiving health-promoting material via this medium. However, delivery via the Internet alone would disadvantage those who are less educated, less financially well off and older. IMPLICATIONS: It is likely that a generational change in the entire nature of public communication will influence the efficiency and effectiveness of preventive health promotion delivery via the Internet. In order to facilitate improved health outcomes, issues of disparity of access must be addressed.     

Evidence of Increasing Coronary Heart Disease Mortality Among Black Men of Lower Social Class

PURPOSE: Few data are available to examine coronary heart disease (CHD) mortality trends by social class in the United States, in contrast to ample data and well-documented social class disparities in CHD in Europe. In addition, previous analyses of U.S. national data indicated that the rate of decline in CHD mortality slowed substantially for blacks in the 1980s. Using a recently published method for calculating mortality rates by social class, we examined trends in CHD mortality for black men and white men aged 35–54 in North Carolina from 1984 to 1993.

METHODS: Men were assigned to one of four social classes: primary white collar (I), secondary white collar (II), primary blue collar (III), or secondary blue collar (IV), based on usual occupation as recorded on the death certificate. Population denominators for each social class were constructed using data from census Public Use Microdata Sample files. Average annual percent change in mortality rates for each race–social class group was derived from linear regression of the log-transformed age-adjusted rates.

RESULTS: For black men, CHD mortality increased by 18% in social class II, by 2% in social class III, and by 6% in social class IV over the 10-year study period. In contrast, CHD mortality decreased by 33% for black men in social class I (the highest class). CHD mortality declined for all white men, with the greatest decline in social class I and the least decline in social class IV.

CONCLUSIONS: These results suggest that CHD prevention efforts have not benefited black men of lower social class, and that public health programs need to be targeted to these men.     

Web Sites of the NCI-Designated Comprehensive Cancer Centers

Abstract

A presence on the World-Wide Web can enhance or diminish an institution's reputation among potential consumers. The Web sites of the twenty-six NCI-designated comprehensive cancer centers range from nonexistent to elaborate, with content to match. This brief review of the comprehensive cancer centers' Web sites takes the patient's and the referring physician's point of view, focusing on treatment information and patient support information. In addition, visual attractiveness, approachability, navigational ease, informational depth, and use of language are weighed in this assessment.     

Pharmaceutical Companies as a Source of Health Information: A Pilot Study of the Effects of Source,Web Site Interactivity,and Involvement

While pharmaceutical companies provide abundant health and medical information on their Web sites, little is known about consumers' perceptions of pharmaceutical companies as a health information source and the impact of pharmaceutical Web sites on health-related attitudes and behaviors. Findings from this study suggest that a pharmaceutical company can be perceived to be just as credible as a government health agency, and that Web site interactivity and consumer involvement with online health information affect the persuasive effects of the pharmaceutical company's message. Implications for future research and for the role of pharmaceutical companies in health communication are discussed.     

我国吸烟与冠心病关系的Meta-analysis

应用Ｍｅｔａ－ａｎａｌｙｓｉｓ方法对国内１１个吸烟与冠心病关系的病例对照研究进行了综合定量分析。累积病例为１１７２例，对照为２５０７例，结果表明吸烟与冠心病有关，其合并后的综合ＯＲ为２．２０（１．９１～２．５５）。研究还表明吸烟量与冠心病之间存在剂量效应关系，另外还对影响本研究可能产生的偏倚和混杂进行了讨论。     

先天性心脏病的遗传流行病学研究

为探讨先天性心脏病的遗传方式，对３７５例先天性心脏病进行了遗传流行病学研究，结果显示该病一级亲属患病率为６．９％，遗传度６６．１３％±１．１３％；二级亲属患病率为１．７％，遗传度为３８．２５±８．３％，一、二级亲属加权平均遗传度为６５．６５±１．０９％，遗传因素较为重要。在各级亲属患病中，患病率依次为一级亲属（６．９％）、二级亲属（１．７％）、一般群体（０．８６％）。所以该病基本符合多基因遗传方式，遗传在决定先天性心脏病的易患性上起主要作用     

小剂量螺内酯治疗冠心病慢性心力衰竭的疗效及安全性分析

目的探讨小剂量螺内酯治疗冠心病慢性心力衰竭的疗效及安全性分析。方法冠心病慢性心力衰竭患者90例按随机数字表法分为两组,每组各45例。小剂量组加用螺内酯20mg／d,中剂量组加用螺内酯40mg／d。疗程12周。比较两组心功能指标及不良反应,并评价疗效。结果小剂量组总有效率为93．33％（42／45）,中剂量组为95．56％（43／45）,差异有统计学意义（p>0.05）。两组LVMI、LVDd、E/A、LVEF均较治疗前显著改善（t=4．31、4．92、4．11、4．62、6．34、5．78、5．56和5．92,P〈0．05）：两组比较,上述指标均无显著差异（t=1．13、0．90、1．10和2．01,P〉0．05）。中剂量组出现3例高血钾．3例乳腺增生,两组不良反应比较,差异有统计学意义（P〈0．05）。结论小剂量螺内酯治疗冠心病慢性心力衰竭可逆转心室重构,改善心功能．安全性更优,值得临床推广应用。     

巨细胞病毒感染与冠心病关系的Meta分析

目的 采用Meta分析对国内已发表的有关巨细胞病毒(CMV)感染与冠心病(CHD)的相关文献进行综合分析，以明确CMV感染是否为CHD危险因素。方法 全面收集有关CMV感染与CHD关系的血清流行病学研究资料，利用RevMam软件进行固定效应模型和随机效应模型的Meta分析。对不同纳入标准的结果进行了敏感性分析。结果 本研究全部文献Meta分析的0R(95％CI)为4．76(2．85-7．97)；采用ELISA法、PCR法检测CMVIgG抗体的研究资料Meta分析的0R(95％CI)分别为2．69(1．36—5．31)，5．75(4．22—7．83)；敏感性分析结果提示不同纳入标准的研究资料的Meta分析结果一致。结论 CHD患者存在CMV感染，CMV感染是CHD的一个危险因素。     

广西城市居民冠心病的疾病经济负担分析研究

目的对广西城市居民冠心病经济负担进行分析。方法资料来源于分层随机调查1997—2001年各级医院确诊的冠心病病人住院和门诊治疗费用及政府部门统计报表。主要利用直接医疗费用计算疾病负担。结果冠心病病人2003年例均门诊费用和例均住院费用分别为203．89元和9477．63元；2003年35岁以上城市居民因冠心病而损失的伤残调整寿命年(DALY)为1．91DALYs／千人口，造成间接经济损失总和为1181.65万元。结论冠心病给广西城市居民带来沉重的经济负担，且呈上升趋势，因此，应积极开展冠心病的预防工作。