Medical information on the internet

Objective

To assess medical information provided in a medically oriented Internet discussion group, in terms of the professional status of the individuals providing information, the consistency of the information with standard medical practice, and the nature of the evidence cited in support of specific claims or recommendations.

Design

Standardized review of 1,658 consecutive messages on a particular online discussion group during a 5-month period.

Setting

An online discussion group for sufferers of painful hand and arm conditions.

Subjects

All participants in this discussion group during the study period.

Measurements and main results

Professional training of those offering medical information, consistency of the advice and recommendations offered with conventional medical practice, and nature of evidence cited in support of medical claims were determined. Of all messages, 55.9% (927) addressed a medical topic. Of these, 79% (732) provided medical information, of which 89.3% (654) were authored by persons without professional medical training, and 5.1% (37) were authored by trained health professionals. Approximately one third of the medical information provided was classified as unconventional. Personal experience was the basis of information provided in 61% of the nonprofessionals’ messages and 13.5% of the professionals’ messages, while no source was given as the basis of information provided in 29.8% of the nonprofessionals’ messages and 67.6% of the professionals’ messages. A published source was cited in 9.2% of the nonprofessionals’ and 18.9% of the professionals’ messages.

Conclusions

These findings suggest that medical information available on Internet discussion groups may come from nonprofessionals and may be unconventional, based on limited evidence, and/or inappropriate.     

Inflammatory bowel disease: An evaluation of health information on the internet

AIM To evaluate the quality and accuracy of websites written to the public on inflammatory bowel disease(IBD)(Crohn's disease and ulcerative colitis) and assess their readability level.METHODS Google?, Bing?, and Yahoo? search engines were searched independently by three researchers in December 2014. Only English-language websites were selected on the basis of predetermined inclusion and exclusion criteria. Researchers independently evaluated the quality of each website by using the DISCERN and the HONcode instruments. The readability levels were calculated using two formulas; the Flesch-Kincaid Grade Level Index, and the Coleman-Liau Readability Index. The agreement between the evaluators was calculated using Cohen kappa coefficient.RESULTS Eighty-four websites were finally identified. Scores varied from a minimum DISCERN score of 18 to a maximum of 68 [mean ± SD, 42.2 ± 10.7; median = 41.5, interquartile range, interquartile range (IQR) = 15.8] and a minimum score of HONcode of 0.14 and a maximum of 0.95 (mean ± SD, 0.16 ± 0.19; median = 0.45, IQR = 0.29). Most of these websites were reviewed in 2014 and 2015 (n = 51). The creators of these websites were: universities and research centers(n = 25, 30%), foundations and associations (n = 15, 18%), commercial and pharmaceutical companies(n =25, 30%), charities and volunteer work(n = 9, 10%), and non-university educational bodies (n = 10, 12%). The Flesch-Kincaid Grade Level readability score(mean ± SD) was 11.9 ± 2.4 and the Coleman-Liau Readability Index score was 12.6 ± 1.5. Significant correlation was found between the two readability scores (R2 = 0.509, P = 0.001). The overall agreement between evaluators measured by Cohen kappa coefficient was in the range of 0.804-0.876; rated as "Good".CONCLUSION The DISCERN and the HONcode scores of websites varied and the readability levels of most websites were above the public readability level. The study highlights the areas that need further improvement and development in patient education online materials about IBD.     

The impact of health information on the internet on the physician-patient relationship: patient perceptions

BACKGROUND: Use of the Internet for health information continues to grow rapidly, but its impact on health care is unclear. Concerns include whether patients' access to large volumes of information will improve their health; whether the variable quality of the information will have a deleterious effect; the effect on health disparities; and whether the physician-patient relationship will be improved as patients become more equal partners, or be damaged if physicians have difficulty adjusting to a new role. METHODS: Telephone survey of nationally representative sample of the American public, with oversample of people in poor health. RESULTS: Of the 3209 respondents, 31% had looked for health information on the Internet in the past 12 months, 16% had found health information relevant to themselves and 8% had taken information from the Internet to their physician. Looking for information on the Internet showed a strong digital divide; however, once information had been looked for, socioeconomic factors did not predict other outcomes. Most (71%) people who took information to the physician wanted the physician's opinion, rather than a specific intervention. The effect of taking information to the physician on the physician-patient relationship was likely to be positive as long as the physician had adequate communication skills, and did not appear challenged by the patient bringing in information. CONCLUSIONS: For health information on the Internet to achieve its potential as a force for equity and patient well-being, actions are required to overcome the digital divide; assist the public in developing searching and appraisal skills; and ensure physicians have adequate communication skills.     

网络中预防医学信息的组织和利用

网络的出现和发展 ,使信息交流迈进了前所未有的崭新的历史时期 ,它超越时空的界限 ,让全世界得以共享一个网络化的虚拟社会 ,为人类的信息交流提供了广阔的空间。网上的信息包罗万象 ,形成了全球最大的信息资源的超级市场。同时由于因特网的开放性 ,大量不准确不客观粗制滥造的信息充斥网上 ,给科研人员信息的获取造成障碍 ,加之现阶段网上信息 90 %以上是英文信息 ,许多从事预防医学科研工作的人员由于语言障碍而无法随意浏览网上的信息 ,造成网上信息的有效利用率较低。因此大力开发网络中的预防医学信息资源并加以科学的组织管理 ,以方…     

Patient use of the internet for information in a lung cancer clinic

STUDY OBJECTIVES: To determine how frequently patients attending a lung cancer clinic use the Internet for their own health information, to determine whether there are demographic differences between Internet users and nonusers, and to determine how patients compare the quality of Internet information with other sources of lung cancer information. DESIGN: Sequentially administered patient questionnaire. One hundred eighty-four patients were surveyed, and 139 patients (75.5%) completed the questionnaire. SETTING: A multidisciplinary thoracic oncology clinic in a Midwestern University hospital. Patients or participants: Patients attending the multidisciplinary thoracic oncology clinic over a 3-month period. Measurements and results: The Internet was the most commonly used nonphysician source of information among our patients. Sixteen percent of the patients sought information on the Internet, but 60% expressed interest in using the Internet for information. Users were on average of higher income level and educational attainment but did not differ from nonusers by community size. Internet users rated the quality of information available on the Internet of similar quality to information from all sources. CONCLUSIONS: Older patients are increasing using the Internet for self-education in lung cancer. While certain barriers continue to exist, patients from rural areas use the Internet to the same degree, as do patients from urban areas. Patients do, however, overrate the quality of information on the Internet.     

The quality of information available on the internet about aortic aneurysm and its endovascular treatment

Introduction and objectives

To evaluate the readability, accessibility, usability, and reliability of information available on the Internet in the Spanish language about aortic aneurysm and its endovascular treatment, and to determine whether this information source provides comprehensible material that will enable patients to participate in decisions regarding their condition.

Methods

In November 2010, information from the Internet was compiled by entering the terms “aneurisma aorta” (aortic aneurysm) and “endoprótesis aorta” (aortic endoprosthesis) in the most widely used search engines: Google, Yahoo, and MSN/Bing. The first 30 pages provided by each search engine were analyzed. The Inflesz software was used to calculate the readability of the information retrieved and the LIDA instrument, a validated tool to evaluate the quality of health-related Web sites, was used to assess accessibility, usability, and reliability.

Results

The results for Web pages containing the terms aneurisma aorta and endoprótesis aorta indicated that the readability of the material retrieved was “somewhat difficult” based on the Flesch index within Microsoft Word (48.3 ± 11.42 and 50.11 ± 9.33, respectively; P=.87), Flesch-Szigriszt index (52.69 ± 8.86, 49.31 ± 7.24; P=.87), Fernández-Huerta index (58.05 ± 8.5, 54.44 ± 7.19; P=.82), and Gunning-Fog index (22.03 ± 2.05, 23.86 ± 1.59; P=.83), as well as the Inflesz grading scale (2.39 ± 0.7, 2.08 ± 0.64; P=.28). The LIDA values for accessibility (82.28 ± 14.14, 77.77 ± 12.64; P=.98), usability (72.28 ± 16.67, 72.28 ± 26.61; P=.08), and reliability (46.17±28.69, 56.38±16.17; P=.06) and the total score (70.22±16.85, 72.15±14.93; P=.52), yielded an evaluation of “moderate”.

Conclusions

The Internet information on aortic aneurysms and its endovascular treatment with aortic endoprostheses was deficient with regard to accessibility, usability, and reliability, and had the added difficultly of complicated readability. Our results suggest that readability indexes should be incorporated in the creation and improvement of Web sites providing medical information related to cardiovascular disease.Full English text available from: www.revespcardiol.org     

Prepared patients: internet information seeking by new rheumatology patients

OBJECTIVE: To investigate to what extent and why new rheumatology patients access medical information online prior to first appointments and secondarily to ask whether they discuss information gained from the Internet with physicians. METHODS: Research was conducted in a teaching rheumatology clinic with a nonrandom sample of 120 English-speaking adults presenting for first appointments in rheumatology. Quantitative and qualitative data were gained in pre- and postappointment patient surveys and interviews, including online information gathering prior to first appointment, demographics, health status, information usage in patient-physician interactions, and satisfaction. Data were analyzed for significant relationships across variables and for qualitative insights into quantitative outcome measures. RESULTS: Of all patients, 87.5% looked up their symptoms or suspected condition prior to their first appointment and 62.5% of all patients sought that information on the Internet. Only 20% of online information seekers discussed that information with their physicians. Age and sex were significant predictors of Internet information seeking. Physician and patient appointment satisfaction was significantly higher when Internet information was discussed; however, most patients did not discuss their information seeking because they primarily feared being perceived as challenging their physician. CONCLUSION: The majority of patients research their conditions online prior to initial appointments, but are unlikely to discuss that research with physicians even though discussion is related to higher satisfaction. Physicians may want to consider strategies for enabling communication about online research.     

Health-related services on the internet

The primary objective of this study is to evaluate a sample of health-related services available on the internet. In addition, types of new services and service qualities that may be required in the future were estimated. A registered nurse using a questionnaire containing items about usability, quality, and other characteristics related to the subject carried out an evaluation of 100 health-related internet sites, and the results were processed to determine average qualities and graphical presentations for the studied parameters. The services studied differed greatly from each other both in terms of content and quality. A general observation was that sites of larger organizations were, typically, both in terms of presentation and content, more sophisticated than sites of smaller producers. A typical characteristic was the superficiality of the information presented. In conclusion, the internet is an emerging medium for health-related information, and standards for the production and presentation of health content for the internet are still in development. However, even at this early stage, the internet represents a valuable source of information for those in need of health-related information for both health care professionals and consumers.     

Digestive disease resources on the internet

The aim of this study is to help digestive disease professionals fully utilize the resources available on the Internet for patient care, education, and research. The following search resources were employed to locate websites: general search engines--Lycos, Metacrawler, Webcrawler, and Yahoo!; medical search engines--HealthWeb, MedMatrix, MedWeb, and MedWebPlus; website links; and publications. The inclusion of web sites was based on their content. Each site was evaluated with respect to its authorship, attribution, currency, and disclosure. All digestive disease professional organizations and academic centers that met the above criteria were included. Only nutrition sites with relevance to digestive diseases were included. A variety of very useful web sites related to digestive diseases exist on the Internet, and their numbers are growing. Many of these sites have valuable information that can be used to improve patient care, promote medical education, and facilitate research. Digestive disease professionals should adopt the Internet and address the many issues raised by this technology.