What Do Evaluation Instruments Tell Us About the Quality of Complementary Medicine Information on the Internet?

Background

Developers of health information websites aimed at consumers need methods to assess whether their website is of “high quality.” Due to the nature of complementary medicine, website information is diverse and may be of poor quality. Various methods have been used to assess the quality of websites, the two main approaches being (1) to compare the content against some gold standard, and (2) to rate various aspects of the site using an assessment tool.

Objective

We aimed to review available evaluation instruments to assess their performance when used by a researcher to evaluate websites containing information on complementary medicine and breast cancer. In particular, we wanted to see if instruments used the same criteria, agreed on the ranking of websites, were easy to use by a researcher, and if use of a single tool was sufficient to assess website quality.

Methods

Bibliographic databases, search engines, and citation searches were used to identify evaluation instruments. Instruments were included that enabled users with no subject knowledge to make an objective assessment of a website containing health information. The elements of each instrument were compared to nine main criteria defined by a previous study. Google was used to search for complementary medicine and breast cancer sites. The first six results and a purposive six from different origins (charities, sponsored, commercial) were chosen. Each website was assessed using each tool, and the percentage of criteria successfully met was recorded. The ranking of the websites by each tool was compared. The use of the instruments by others was estimated by citation analysis and Google searching.

Results

A total of 39 instruments were identified, 12 of which met the inclusion criteria; the instruments contained between 4 and 43 questions. When applied to 12 websites, there was agreement of the rank order of the sites with 10 of the instruments. Instruments varied in the range of criteria they assessed and in their ease of use.

Conclusions

Comparing the content of websites against a gold standard is time consuming and only feasible for very specific advice. Evaluation instruments offer gateway providers a method to assess websites. The checklist approach has face validity when results are compared to the actual content of “good” and “bad” websites. Although instruments differed in the range of items assessed, there was fair agreement between most available instruments. Some were easier to use than others, but these were not necessarily the instruments most widely used to date. Combining some of the better features of instruments to provide fewer, easy-to-use methods would be beneficial to gateway providers.     

消费者对食品添加剂的关注状况及其影响因素分析

目的 了解消费者对食品添加剂的关注水平及其影响因素,为进一步有针对性地宣传食品添加剂知识提供参考依据。方法 采用多阶段分层随机抽样的方法对全国4 575名受访者进行问卷调查,并用统计软件SPSS19.0对数据进行单因素和多因素分析。结果 在4 408份有效问卷中,消费者对食品添加剂的总体关注率为85.5%,其中女性的关注率（88.1%）高于男性（82.7%）,21～30岁年龄组受访者的关注率(88.2%)高于其他年龄组,硕士及以上学历受访者的关注率(96.8%)高于其他学历组,农村（83.8%）受访者的关注率低于城镇（86.8%）,家庭人均月收入为6 501～10 000元受访者的关注率(89.7%)高于其他收入组以及恩格尔系数＜30%的受访者的关注率(79.5%)低于其他组。单因素分析结果显示,不同的性别、年龄、婚姻状况、文化程度、常住地、职业类型、家庭人均月收入以及恩格尔系数在食品添加剂的关注水平上均有统计学差异（P＜0.05）。多因素Logistic回归分析结果显示,性别、文化程度和恩格尔系数是影响消费者对食品添加剂关注状况的重要因素。结论 消费者对食品添加剂的关注水平存在差异,加强文化教育、降低恩格尔系数将有助于提高消费者对食品添加剂的关注水平。     

Integrated risk assessment of a hydroxyapatite-protein-composite for use in oral care products: a weight-of-evidence case study

Risk assessment of cosmetic ingredients represents a regulatory standard requirement in Europe and other regions. An integrated approach was designed to assess the safety of HPC, a particulate composite of hydroxyapatite and protein (gelatin) for use in oral care products, employing a weight-of-evidence assessment and considering specific physico-chemical properties and exposure conditions. An initial evaluation of the constituents suggested that their chemical nature does not represent a particular health hazard per se. Hydroxyapatite is the main component of teeth and bones in mammals; gelatin is used in food and assumed to be safe once a BSE/TSE risk has been excluded. In vitro screening tests were chosen to further evaluate the biocompatibility: Hen's egg test-chorioallantoic membrane (HET-CAM) to assess irritating effects towards mucous membranes; MTT cytotoxicity test with 3T3 fibroblasts; human corneal epithelial models to investigate inflammatory mediators and cytotoxicity; macrophage assays to measure cytotoxicity, inflammatory mediators and oxidative stress. Together with results from clinical studies, exposure estimates and analyses of kinetic properties, the presented information provides sound evidence to support the safe use of HPC. This is an example of a risk assessment for cosmetic use of small particles without the need for additional animal studies.     

特殊膳食用食品与保健食品的认知行为调查分析

目的:了解消费者对特殊膳食用食品和保健食品的认知行为,为进口特殊膳食用食品的管理提供依据。方法:通过对南京市681名消费者的现场问卷调查,分析消费者对特殊膳食用食品和保健食品的认知行为差异。结果:相对于保健食品,消费者对特殊膳食用食品的认知度较低,人们更倾向于购买进口特殊膳食用食品。结论:应采取更为严格的管理措施来保障进口特殊膳食用食品的安全。     

公众健康积极指数量表汉化及在慢性病患者中的信效度研究

目的 汉化英文版公众健康积极指数量表，对其信度和效度进行检验。 方法 遵循Brislin翻译模式，经过翻译、回译、跨文化调适和预调查，采用便利抽样法对江苏省6所社区医疗卫生机构的182例慢性病患者进行测试。 结果 中文版量表的总体Cronbach′s α系数为0.812，重测信度系数为0.979；量表水平的平均内容效度指数（S-CVI/Ave）为0.960，条目水平的内容效度指数（I-CVI）为0.800~1.000；探索性因子分析共提取知识、自我效能及行动3个公因子，累积方差贡献率为68.784%。 结论 中文版量表在慢性病患者中具有良好的信效度，可作为慢性病患者健康积极度的测量工具。     

非处方药说明书理解力调查研究

目的:采用问卷调查的方法了解学生对现行版与实验版说明书的理解力情况.方法:选取某大学最大的教学楼,随机抽取两个自习教室,分别为实验组和对照组.由实验组人员对现行说明书进行改进,拟定新的实验版说明书,两组人群对参照不同说明书(现行版和实验版)完成相同的问卷调查,并对结果进行正确率的计算、t检验和线性回归分析.结果:实验组调查的14项理解力均高于对照组,尤其在用法用量、儿童及老年人用药、孕妇及哺乳期妇女用药和不良反应部分,实验组理解力较对照组明显提高.此外,除年级因素,实验组和对照组的行为得分与其人口学特征都显示出了一定相关性,具有统计学意义.结论:对非处方药说明书内容和格式的优化可明显提高消费者理解力.