In 1997, Piero Impicciatore and his colleagues in Milan set out to examine the reliability of online advice that was available to parents seeking to manage fevers in their children.1 It was one of the first studies of its kind, but it laid the foundation for many, many more.
They utilized the search engines Yahoo and Excite, yielding a list of 41 destinations that matched their search criteria. Even then, their prescient study revealed that 32 of these sites were associated with commercial ventures; only 4 sites provided what they considered to be complete and accurate information.
They concluded then that there was an “urgent need” to monitor public-oriented healthcare information on the internet. If we could somehow provide Dr. Impicciatore and his team with a flux capacitor (it makes time travel possible!), it is interesting to imagine what they might think of the internet today.
Perhaps they would be dismayed by a 2014 study of dermatology on YouTube,2 where we find that one of the top returns for a search of “skin cancer” is an offering entitled, “Dermatologists hate this video!” Shared more than any other video in this study, its viewers are informed that 100% cure rates for melanoma are possible with the use of natural remedies, and Big Pharma doesn’t want you to know about it. The title of this video is indeed apt, though probably not for the reasons that “thetruthergirls” had envisioned.
Once the initial shock had worn off, however, perhaps Dr. Impicciatore would take heart at the growing savvy exhibited by the so-called “health-seekers” of the internet, those who employ the web to gather health or medical information, as defined and polled by the Pew Research Internet Project.3
Compared to more general internet users, these health-seekers show greater skepticism and vigilance in evaluating the online information they retrieve:
- 86% are concerned about unreliable data
- 58% check the source, to determine who is providing the information; this jumps to 61% when considering those with college-level education.
- Only 52% believe that “most” of what they find is credible.
People are getting smarter about their internet use. Wiser. But the fact remains, much of what passes for insight on the web today may be little more than an outdated opinion, a sales pitch, or downright misinformation that could even prove harmful. Mistakes or omissions in this context are legitimate concerns.
The Federal Trade Commission estimates that only about half of the content on health and medical web sites has undergone prior scrutiny by a trained physician,3 and even that estimate feels a bit optimistic. There are many studies in the literature reporting that the quality of most health-related websites is not great, but is generally alright, though nearly all will contain some imperfection or another. Interestingly, there seems to be no great difference, at least in this respect, between commercial and noncommercial sites.
Fortunately, an emerging field of study is the development of direct and indirect criteria to assess the quality of health information found on a webpage. Scoring systems are being devised in the hopes of standardizing such evaluations. My next post will discuss some of the tools and tips used to help differentiate the online wheat from the digital chaff.
- Impicciatore P, Pandolfini C, Casella N, et al. Reliability of health information for the public on the World Wide Web: systematic survey of advice on managing fever in children at home. BMJ. 1997:314:1875-9.
- Boyers LN, Quest T, Karimkhani C, et al. Dermatology on YouTube. Dermatol Online. 2014;20(6).
- Rainie L, Fox S. The quality of information: verify before trusting. Pew Internet & American Life Project.