Presentation on finding credible health information online. What to look for, what to avoid, recommendations for reputable sites.

1. Linda Pourmassina, MD
The Polyclinic
Seattle, WA

2. Background
Why is this topic important?
 Widely applicable
 Can be a source of anxiety.
 We are bombarded by confusing health information.

3. 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?

5. Where do most people look?
 WebMD
 Question/answer sites
 Google

6. Who is feeding us health info?
 Our own doctors

7. Who is feeding us health info?
 Our own doctors (drop in the bucket)

8. 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

9. 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
 Caregivers
http://pewinternet.org/Commentary/2011/November/Pew-Internet-
Health.aspx updated 3/1/2012

10. 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

11. Who runs the website?
.gov (government-sponsored)
.edu (educational institution)
.org (noncommercial organization)
.com (commercial organization)

12. Who is doing the writing?
 “About Us”

14. 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

15. Overview of the website/page
A “critical” first impression
Sloppy?
Spelling errors?
Poor grammar?

16. Overview of website/page
ADVERTISEMENTS
Are they clearly marked?
Reputable organizations make the distinction between
written content and advertising clear.

17. 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.

18. Analyzing content
 Watch out for buzzwords/superlatives

19. Analyzing content
 Watch out for buzzwords/superlatives
BREAKTHROUGH!!

20. Analyzing content
 Watch out for buzzwords/superlatives
BREAKTHROUGH!!
MIRACULOUS!!

21. Analyzing content
 Watch out for buzzwords/superlatives
BREAKTHROUGH!!
MIRACULOUS!!
BESTSELLING!!

22. 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.

23. 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.

24. 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?

25. 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?”

26. 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?

27. 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)?

28. Timing
 References to studies
 mention of date or
 easy link to original article or
 bibliography
 How often is the site updated?

29. Symptom Searches and Self-
diagnosis
 WebMD
 Google
 Mayo Clinic
 scary stuff
anxiety-provoking

30. Symptom Searches and Self-
diagnosis
It’s OK if you looked something up on the web.
If you’re worried about a particular diagnosis, go ahead
and tell your doc.

31. Symptom Searches and Self-
diagnosis
BUT remember, that your doctor will give you the best
possible diagnosis based on your story and his/her
examination of you.

32. 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.

33. Other media (cont.)
• Social media
Have to follow the “right people” to get the best quality health
info

34. Where does your primary care
doctor fit in all this?
 He/she asks the right questions
 Integrates and individualizes
 Unbiased
 Has your interest at heart

35. Recommended health websites

36. MedlinePlus
“MedlinePlus is the
National Institutes of
Health's Web site for
patients and their
families and friends.
Produced by the National
Library of Medicine, it
brings you information
about diseases,
conditions, and wellness
issues in language you
can understand.
MedlinePlus offers
reliable, up-to-date
health information,
anytime, anywhere, for
free.”

37. CDC.gov
“CDC Mission:
Collaborating to create
the expertise,
information, and tools
that people and
communities need to
protect their health –
through health
promotion, prevention
of disease, injury and
disability, and
preparedness for new
health threats.”

38. Cancer.gov
“The National Cancer
Institute coordinates the
National Cancer Program,
which conducts and
supports research, training,
health information
dissemination, and other
programs with respect to
the cause, diagnosis,
prevention, and treatment
of cancer, rehabilitation
from cancer, and the
continuing care of cancer
patients and the families of
cancer patients”

39. MayoClinic.com
Non-profit medical
practice and medical
research group

40. FamilyDoctor.org
“The mission of
FamilyDoctor.org is to
provide scientifically
accurate information
from a family medicine
perspective to improve
the health of all
individuals and
communities”

41. KingCounty.gov
Health section
Local information
From disease outbreaks
to information on
cancer screening to
healthy recipes

42. HealthNewsReview.org
“What is
HealthNewsReview.org?
HealthNewsReview.org is a website
dedicated to:
Improving the accuracy of news
stories about medical treatments,
tests, products and procedures.
Helping consumers evaluate the
evidence for and against new ideas
in health care.
We support and encourage the
ABCs of health journalism.
-Accuracy
-Balance
-Completeness”

47. 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

50. 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

51. 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.

52. THANK YOU.