Linda Pourmassina, MD The Polyclinic Seattle, WA
BackgroundWhy is this topic important? Widely applicable Can be a source of anxiety. We are bombarded by confusing health information.
Outline Where are we getting our health info? Who looks for health info online? How do you analyze a website for credibility? What are some good websites for health information?
Where do most people look? WebMD Question/answer sites Google
Who is feeding us health info? Our own doctors
Who is feeding us health info? Our own doctors (drop in the bucket)
Who is feeding us health info? Our own doctors (drop in the bucket) Radio/TV Magazines News websites Social media Friends/Relatives TV doctors Celebrities
Who looks for health info online? 59% of US adults (80% of internet users) 66% search for info about specific disease/medical problem Women>men Caregivershttp://pewinternet.org/Commentary/2011/November/Pew-Internet- Health.aspx updated 3/1/2012
Who Looks for health info online?“Eight in ten internet users look online for health information, making it the third most popular online activity” From www.pewinternet.org
Who runs the website?.gov (government-sponsored).edu (educational institution).org (noncommercial organization).com (commercial organization)
Who is doing the writing? “About Us” Author credentials Background, education, research Associated with an institution or organization? If so, look up the institution to verify whether it’s legitimate Contact info Ideally, easy to find
Overview of the website/pageA “critical” first impression Sloppy? Spelling errors? Poor grammar?
Overview of website/pageADVERTISEMENTS Are they clearly marked? Reputable organizations make the distinction between written content and advertising clear.
Overview of page/website If ads are not clearly marked, the site’s creators may be more interested in sales than providing you with accurate health info.
Analyzing content Watch out for buzzwords/superlatives
Analyzing content Watch out for buzzwords/superlatives BREAKTHROUGH!!
Analyzing content Watch out for buzzwords/superlatives BREAKTHROUGH!! MIRACULOUS!!
Analyzing content Watch out for buzzwords/superlatives BREAKTHROUGH!! MIRACULOUS!! BESTSELLING!!
Analyzing content Watch out for buzzwords/superlatives BREAKTHROUGH!! MIRACULOUS!! BESTSELLING!! Words generally used to try to convince the reader. Exclamation points and all caps are generally not found in more writing.
Analyzing content Is the information oversimplified? Is it well-balanced? - pros and cons mentioned?The clinical practice of medicine involves a lot of “ifs,” “ands,” and “buts.”The media and press tend to oversimplify to retain viewership.
A Closer Look at Content(Fictional Example) “A recent study shows that drinking grape juice reduces asthma attacks by 50 per cent”Can you point out the potential problems of a statement like this?
A Closer Look at Content(Fictional Example)“A recent study shows that drinking grape juice reduces asthma attacks by 50 per cent” What does “recent” mean? Is the study referenced anywhere? Hyperlinked? Is this a case of the “telephone game?”
A Closer Look at Content(Fictional Example) “A recent study shows that drinking grape juice reduces asthma attacks by 50 per cent” What does “50 per cent” mean? What is the sample size?
A Closer Look at Content(Fictional Example)“A recent study shows that drinking grape juice reduces asthma attacks by 50 per cent” Is there a corresponding advertisement? Or is the website produced by the America’s Grape Growers Association (fictional group)?
Timing References to studies mention of date or easy link to original article or bibliography How often is the site updated?
Symptom Searches and Self-diagnosis WebMD Google Mayo Clinic scary stuffanxiety-provoking
Symptom Searches and Self-diagnosisIt’s OK if you looked something up on the web.If you’re worried about a particular diagnosis, go ahead and tell your doc.
Symptom Searches and Self-diagnosisBUT remember, that your doctor will give you the best possible diagnosis based on your story and his/her examination of you.
Other media Journalism Health reporting is often in the hands of people who are not well-trained to critically appraise studies/journal articles. Omit limitations of studies. “Fear-mongering”/sensationalism attracts viewers. Sometimes do not fact check TV doctors Keep in mind: they work for TV stations who, in turn, care about viewership.
Other media (cont.) • Social media Have to follow the “right people” to get the best quality health info
Where does your primary caredoctor fit in all this? He/she asks the right questions Integrates and individualizes Unbiased Has your interest at heart
MedlinePlus“MedlinePlus is theNational Institutes ofHealths Web site forpatients and theirfamilies and friends.Produced by the NationalLibrary of Medicine, itbrings you informationabout diseases,conditions, and wellnessissues in language youcan understand.MedlinePlus offersreliable, up-to-datehealth information,anytime, anywhere, forfree.”
CDC.gov“CDC Mission:Collaborating to createthe expertise,information, and toolsthat people andcommunities need toprotect their health –through healthpromotion, preventionof disease, injury anddisability, andpreparedness for newhealth threats.”
Cancer.gov“The National CancerInstitute coordinates theNational Cancer Program,which conducts andsupports research, training,health informationdissemination, and otherprograms with respect tothe cause, diagnosis,prevention, and treatmentof cancer, rehabilitationfrom cancer, and thecontinuing care of cancerpatients and the families ofcancer patients”
MayoClinic.comNon-profit medicalpractice and medicalresearch group
FamilyDoctor.org“The mission ofFamilyDoctor.org is toprovide scientificallyaccurate informationfrom a family medicineperspective to improvethe health of allindividuals andcommunities”
HealthNewsReview.org“What isHealthNewsReview.org?HealthNewsReview.org is a websitededicated to:Improving the accuracy of newsstories about medical treatments,tests, products and procedures.Helping consumers evaluate theevidence for and against new ideasin health care.We support and encourage theABCs of health journalism.-Accuracy-Balance-Completeness”
Can “.edu” be trusted? “Academic Medical Centers Often Guilty of Research Hype” Wall Street Journal Blogs 5/4/2009 “Press Releases by Academic Medical Centers: Not So Academic” “Conclusion: Press releases from academic medical centers often promote research that has uncertain relevance to human health and do not provide key facts or acknowledge important limitations.” Woloshin, S, et al. Annals of Internal Medicine May 5, 2009 vol. 150 no. 9 613-618
Conclusion Evaluate for the following: Who is responsible for the content? Are advertisements clearly marked? Is the information well-balanced? (Pros/cons) Is the content clearly dated? Are there timely updates? Be careful: Of sites that have advertising for their own products Of web content that is based on personal experience and opinion Avoid: Superlatives, all caps, exclamation points Sites where advertising is “sneaky.” Sites that want your personal health information
Conclusion Take breaking news in health with a grain of salt. There are very few encyclopedic-level authorities when it comes to health information online. Partner with a doctor you trust. Have a primary care doctor. The good news: we are already seeing a movement towards the promotion of better health information online.