This document discusses the opportunities and challenges of using social media and the internet for health information and promotion. It notes that while 59% of internet users search for health information online, only 43.5% of websites provide accurate information on infant sleep safety. The document cautions that 72% of adults believe most health information online without consistently checking sources or dates. It specifically examines Suzanne Somers' promotion of bioidentical hormone therapy and notes the lack of evidence for its superiority claims over FDA-approved synthetic hormones. The downsides discussed are inaccurate non-evidence based information and increased vulnerability of less educated individuals.

1. Social media and patient
engagement
Leah S. Millheiser,MD,FACOG,IF
Clinical Assistant Professor
Director, Female Sexual Medicine Program
Department of Obstetrics and Gynecology
Stanford University School of Medicine

2. Social media and health
promotion
• Promote healthy habits and lifestyles
• Prevention of chronic illnesses
• Transform health communication
• Potential to reach and engage women for
sexual health promotion
• Major source of advice regarding illnesses,
treatment options, dietary advice and
disease prevention

3. Health information accuracy
on the internet
• Chung et al. Safe Infant Sleep
Recommendations on the Internet: Let’s Google
It. J Peds 2012:
– Identify websites that accurately reflect the
American Academy of Pediatrics
recommendations for infant sleep safety.
– 1300 web sites reviewed
– 43.5% accurate information
– 28.1% inaccurate information

4. Pew Internet & American
Life Project
• 59% of American internet users go online for health
information
– 80% of searches begin at search engine
• 35% US adults are “online diagnosers”
– Women >>> Men
– 41% had diagnosis confirmed by MD
• 72% of adults believe most or all of the health
information found on the internet
• 75% do not consistently check source or date of
health information
Fox S, Duggan M. Health Online 2013

5. The case of Suzanne Somers &
Bioidentical Hormone Therapy
(BIH)

6. According to the “Experts”…
• “Bioidentical HT”
– Natural because made
from soy/yam
– Bioidentical estrogen
≠increase the risk of
breast cancer
– Survival rate of women
with breast cancer is
“considerably better” if
they take bioidentical
estrogen
– Bioidentical HT
decreases every cause
of death in women
• “Synthetic HT”
– Unnatural because
made in a lab
– Derived from horse
urine

7. 2012 ACOg Committee Opinion:
Compounded BIH
• Evidence lacking to support superiority claims of
compounded bioidentical hormones
• Lacking large studies of safety and efficacy
• Compounded pharmacies not regulated by the FDA
– Underdosage vs. overdosage
– Variable purity and potency
• Salivary levels ≠ a reasonable representation of
endogenous, circulating serum hormones

8. health education on the
internet
• Discretely obtained information
• Potential to affect sexual attitudes and behaviors
• Seek useful information from a wide range of
resources
• Low cost
• Provide health information to individuals who
may not be able to seek care through
conventional means

9. What’s The Downside?
• Inaccurate information/non-evidence
based
• False identities – claims to be expert
• Increased vulnerability of individuals with
less education

10. JAMA Benchmarks
• Authorship
– Identification of authors/contributors
• Attribution
– Sources of information
• Disclosures
– Site ownership, conflicts of interest, etc.
• Currency
– How often is the site updated/age
of site

12. Thank You!
Drleahm.com