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Millions of people are using the internet to get health information. And thousands of websites are offering health information. Some of those sites are reliable and up-to-date; some are not. How can you tell the good from the bad?

First, it's important to carefully consider the source of information and then to discuss the information you find with your health care professional. These questions and answers can help you determine whether the health information you find on the internet or receive by email from a website is likely to be reliable.

Evaluating internet health information

Who runs the website?

Any good health website should make it easy to learn who is responsible for the site and its information. On the U.S. Food and Drug Administration's (FDA) website, for example, the FDA is clearly noted on every major page, along with a link to the site’s home (main) page, www.fda.gov http://www.fda.gov

Information about who runs the site can often be found in an "About Us" or "About this website" section, and there's usually a link to that section on the site’s home page.

What is the purpose of the website?

Is the purpose of the site to inform? Is it to sell a product? Is it to raise money? If you can tell who runs and pays for the site, this will help you evaluate its purpose. Be cautious about sites trying to sell a product or service.

Quackery abounds on the web. Look for these warning signs and remember the adage "If it sounds too good to be true, it probably is."

• Does the site promise quick, dramatic, miraculous results? Is this the only site making these claims?
• Beware of claims that one remedy will cure a variety of illnesses, that it is a "breakthrough", or that it relies on a "secret ingredient".
• Use caution if the site uses a sensational writing style (lots of exclamation marks, for example.)
• A health website for consumers should use simple language, not technical jargon. Get a second opinion. Check more than one site.
• If a health website does use technical jargon, i.e. medical or nursing jargon, it should explain simply what it means

What is the original source of the information on the website?

Always pay close attention to where the information on the site comes from. Many health and medical websites post information collected from other websites or sources. If the person or organization in charge of the site did not write the material, the original source should be clearly identified. Be careful of sites that don’t say where the information comes from.

Good sources of health information include -

• Sites that end in ".gov", sponsored by the federal government, like the U.S. Department of Health and Human Services www.hhs.gov http://www.hhs.gov, the FDA www.fda.gov http://www.fda.gov, the National Institutes of Health www.nih.gov http://www.nih.gov, the Centers for Disease Control and Prevention www.cdc.gov http://www.cdc.gov, and the National Library of Medicine www.nlm.nih.gov http://www.nlm.nih.gov
• .edu sites, which are run by universities or medical schools, such as Johns Hopkins University School of Medicine and the University of California at Berkeley Hospital, health system, and other health care facility sites, like the Mayo Clinic and Cleveland Clinic.
• .org sites maintained by not-for-profit groups whose focus is research and teaching the public about specific diseases or conditions, such as the American Diabetes Association, the American Cancer Society, and the American Heart Association.
• Medical and scientific journals, such as The New England Journal of Medicine and the Journal of the American Medical Association, although these aren't written for consumers and could be hard to understand.
• Sites whose addresses end in .com are usually commercial sites and are often selling products.

How is the information on the website documented?

In addition to identifying the original source of the material, the site should identify the evidence on which the material is based. Medical facts and figures should have references (such as citations of articles in medical journals). Also, opinions or advice should be clearly set apart from information that is "evidence-based" (that is, based on research results).

How is information reviewed before it is posted on the website?

Health-related websites should give information about the medical credentials of the people who prepare or review the material on the website.

How current is the information on the website?

Websites should be reviewed and updated on a regular basis. It is particularly important that medical information be current, and that the most recent update or review date be clearly posted. These dates are usually found at the bottom of the page. Even if the information has not changed, it is helpful to know that the site owners have reviewed it recently to ensure that the information is still valid. Click on a few links on the site. If there are a lot of broken links, the site may not be kept up-to-date.

How does the website choose links to other sites?

Reliable websites usually have a policy about how they establish links to other sites. Some medical websites take a conservative approach and do not link to any other sites; some link to any site that asks or pays for a link; others link only to sites that have met certain criteria. Look for the website’s linking policy, often found in a section titled "About This Web Site".

What information about its visitors does the website collect, and why?

Websites routinely track the path visitors take through their sites to determine what pages are being used. However, many health-related websites ask the visitor to "subscribe" or "become a member". In some cases, this may be done so they can collect a fee or select relevant information for the visitor. In all cases, the subscription or membership will allow the website owners to collect personal information about their visitors.

Many commercial sites sell "aggregate" data about their visitors to other companies - what percent are women with breast cancer, for example. In some cases, they may collect and reuse information that is personally identifiable, such as a visitor’s ZIP code, gender, and birth date.

Any website asking users for personal information should explain exactly what the site will and will not do with the information. The FDA website, for example, spells this out in its Privacy Statement. Be sure to read and understand any privacy policy or similar language on the site, and don't sign up for anything you don't fully understand.

How does the website manage interactions with visitors?

There should always be a way for visitors to contact the website owners with problems, feedback, and questions. The FDA’s website provides contact information on its Contact Us page.

If the site hosts a chat room or other online discussion areas, it should tell its visitors about the terms of using the service. Is the service moderated? If so, by whom, and why? It is always a good idea to spend time reading the discussion without joining in, to feel comfortable with the environment, before becoming a participant.

Can the accuracy of information received in an email be verified?

Carefully evaluate email messages. Consider the origin of the message and its purpose. Some companies or organisations use email to advertise products or attract people to their websites. The accuracy of health information may be influenced by the desire to promote a product or service.

Is the information that’s discussed in chat rooms accurate?

Assessing the reliability of health information that you come across in web discussion groups or chat rooms is at least as important as it is for websites. Although these groups can sometimes provide good information about specific diseases or disorders, they can also perpetuate misinformation. Most internet service providers don't verify what is discussed in these groups, and you have no way of knowing the qualifications or credentials of the other people online. Sometimes people use these groups to promote products without letting on that they have a financial stake in the business. It’s best to discuss anything you learn from these groups with your health care professional.

Related Resources

Healthfinder

http://www.healthfinder.gov/

A DHHS site that is a gateway to consumer information. Its goal is to improve consumer access to selected health information from government agencies, their partner organizations, and other reliable sources that serve the public interest.

MEDLINEplus

http://www.medlineplus.gov/

A consumer-oriented website established by the National Library of Medicine, the world’s largest biomedical library and creator of the MEDLINE database. It offers health, drug, and disease information.

MEDLINEplus Evaluating Health Information

http://www.nlm.nih.gov/medlineplus/evaluatinghealthinformation.html

MEDLINEplus Healthy Websurfing

http://www.nlm.nih.gov/medlineplus/healthywebsurfing.html

ClinicalTrials.gov

http://www.clinicaltrials.gov/

A site created by the National Institutes of Health and the Food and Drug Administration to provide patients, family members, and members of the public with current information about clinical research studies and clinical trials.

A Quick Checklist

You can use the following checklist to help make sure that the health information you are reading online can be trusted.

• [ ] Can you easily see who sponsors the website?
• [ ] Is the sponsor a government agency, a medical school, or a reliable health-related organization, or is it related to one of these?
• [ ] Is there contact information?
• [ ] Can you tell when the information was written?
• [ ] Is your privacy protected?
• [ ] Does the website make claims that seem too good to be true? Are quick, miraculous cures promised?

Source - How to Evaluate Health Information on the Internet, 2005

http://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/BuyingMedicinesOvertheInternet/ucm202863.htm