Do you realize that when you are looking for health information on the Internet, you are searching through 186 million Web sites? Even if you limit your search to sites focusing specifically on health, you are still likely to be looking through millions of sites.
Given the sheer volume of health information online, how do you find the specific information you need? And once you find it, how do you determine whether the source of the information is reliable?
As more and more people are turning to the Internet for health information, and as the Internet continues to expand, these questions take on greater and greater importance. This article describes some ways to streamline your Internet searching and to evaluate the trustworthiness of the Web sites you visit.
Many Web sites display images of awards or trophies along the sides or at the bottom of the home page. While they may suggest quality, many such awards are given for good design or other, stylistic aspects of the site, not for quality or reliability of information.
The one seal that does indicate that the contents of a health site have been reviewed by medical professionals (unless clearly stated otherwise on the site) is the HONcode, which stands for Health on the Net Foundation Code of Conduct. (See the footer of this Web page for an example of this seal.) To have a Web site reviewed, the Web site author or designer must complete a set of Web site design and content principles established by the HONcode foundation. Among other things, the Web site must indicate the qualifications of the authors, state where the information came from (such as published research studies), and provide evidence supporting any claims relating to the benefits or performance of a particular treatment, product, or service.
To prove that the principles have been met, an application for review and approval to display the HONcode seal on the Web site is made online through HONcode. Any Web site showing the HONcode seal means the Web site was approved by the foundation and met its design and content principles.
The HONcode Web site, www.hon.ch/HONcode, has several searchable databases to help consumers find information on a variety of medical topics. To use these databases, click on “HONsearch” on the home page. You will have the option of searching just Web sites that are HONcode certified or broadening your search to include certified and noncertified sites.
If you find a Web site you like that does not display the HONcode seal, be careful about trusting the health information presented. It may be a good site, but it would be wise to double-check the information on other Web sites or printed resources.
To filter the 186 million active Web sites into something more manageable for individual users, various organizations have built health information portals. A portal may be structured as a directory and provide a listing of health Web sites, or it may be a search engine that searches only Web sites with health information. Some health portals provide a combination of these features. And some additionally compile health information from a variety of sources and present it directly on the site. The information presented in or linked to by a health information portal is reviewed for quality information, so you can feel confident about using it.
Portals with directories generally organize their lists of Web sites alphabetically or categorically. For example, Healthfinder.gov (www. healthfinder.gov/HealthAtoZ) organizes links to information on more than 1,600 health-related topics alphabetically by category. Clicking on a category heading leads to a page of links to relevant Web pages.
A quick way to navigate when using a health information directory is to use the hierarchical path that is displayed at the top of the page. For instance, on Healthfinder.gov, “Health A to Z” is an option to click on the home page. If “A” is selected, all the health subjects beginning with “A” appear, and the hierarchical path “Home > Health A—Z >” shows at the top of the page. If “Anemia” is then selected as the subject of interest, links to Web pages presenting information on anemia appear, and the path at the top of the page reads “Home > Health A—Z > A >.” To go back to a page visited previously, just click on it in the hierarchical path (rather than clicking your browser’s “back” button).
An example of a health information portal that provides both a directory of Web site links and health information compiled from a variety of sources is Yahoo! Health (http://health.yahoo.net). Yahoo! Health provides selected news stories on health, as well as articles and videos on a variety of medical conditions and health-related topics.
An example of a health information portal with a specialized search engine that searches only a proprietary database of health Web sites is Healthline (http://healthline.com). Using a smaller, subject-specific search engine such as Healthline can dramatically reduce the amount of time necessary to scan through search results, since all the search results will be Web sites that present health information. Some specialized search engines have tools that allow you to narrow your search results even further. Healthline, for example, allows you to filter your results according to symptoms, treatments, or drugs. It is also possible to search on more than one term at once – for example, “diabetes, blindness” – to reduce the number of search results.
You can find other health information portals by typing the phrase “health information portal” into a general search engine such as Google.
Looking for the HONcode on the Web sites you visit and using a health information portal can help you find quality health information. But you also need to use your own judgment to assess quality, particularly if the contents of a site aren’t reviewed by health professionals. An acronym that can help you make that assessment is SPAT, which stands for Site, Publisher, Audience, and Timeliness. It should take you less than 10 seconds to check these four items on any site. If all of them meet your criteria for acceptability, the Web site most likely presents health information you can use. However, if any one of them doesn’t, look elsewhere for the information you need.
Site. The URL (uniform resource locator) is a Web site’s “address.” In some cases, it can help you identify who or what organization is behind the site. For example, www.diabetesselfmanagement.com is the Web site hosted by Diabetes Self-Management. In other cases, the URL does not tell you who is hosting the site, and you need to look elsewhere on the site to find that information.
The part of the URL commonly called the suffix, or extension, however, does tell you what type of entity is behind the site. The most common suffixes are .com (commercial business), .org (nonprofit organization), .edu (educational institution), .net (Web hosting company or computer network group), and .gov (government agency). You may also see country codes in URLs, such as .ca (Canada), .uk (United Kingdom), and .ch (China), indicating where in the world the site originates.
It’s important to note that there are currently no rules for who can use a given suffix; anyone can have whatever suffix they want. So far, however, .coms, .orgs, .edus, .nets, and .govs are usually what they claim to be.
You may find good information on any of these types of sites. But because commercial businesses are out to make a profit, they may tailor the information they present to make their product or service look good. If you’re wondering whether the information you read on a .com site is biased toward that company’s interests, double-check the information on another type of site.
When you find a Web site that you think you may want to visit again or mention to someone else, either bookmark the site in your browser, or copy and paste the URL into a document.
Publisher. There should always be a name on the Web site claiming ownership and taking responsibility for the Web site content. The publisher is usually listed at the bottom of the home page. If there is no publisher listed, the information is suspect and you should search elsewhere.
Having a writer’s name attached to the site or to the article and other media on the site is another way for you to check its credibility. Is this person a well-known authority? Does the site list his credentials and any affiliations (such as to a hospital or university)? Can you find other works by this writer elsewhere on the Internet? Knowing about the writer helps you know more about where the information is coming from and how reliable it is.
Audience. The audience of a Web site is the readers for whom the content is intended. For example, some health Web sites are intended for medical professionals, and some are intended for nonprofessionals. Those aimed at professionals tend to assume a certain amount of medical knowledge and to use more scientific language and technical terms. They are likely to be less useful to most nonprofessionals. To get the most from a health Web site, look for one that you can readily understand.
Timeliness. Since some health information changes quickly, while some stays the same for years, you need to know whether the information you are reading is up to date, so look for dates on the Web sites you visit. Most often, a copyright date can be found at the bottom of the home page, near the publisher’s name. That may tell you that the publisher is actively maintaining the Web site – if the date is current – but it doesn’t necessarily tell you when content items were written or posted online.
Some Web sites list a date for the creation of the Web site, some have a date for the creation of each content item on the Web site, some list the date that content items were posted, and some have “reviewed” or “updated” dates. Ideally, a review or an update would mean that all of the information in the article or other item has been thoroughly checked and updated. It can mean that, and some sites even tell you who updated it. But it doesn’t always: Sometimes it just means that someone check all the links embedded in an article or checked that the images look OK. Currently, there is no foolproof way of knowing what “updated” means unless the site spells it out somewhere.
Generally, people look for health information on the Internet to better understand a condition that they or a family member has, or to research ways to treat or manage a medical condition. Educating yourself in this way is a terrific way to take greater charge of your health. However, before you make big changes in your diet, exercise regimen, or some other part of your lifestyle, and before you start using any dietary supplements you may have read about online, check it out with your health-care provider. Even products or practices that sound safe and healthful may have little-known side effects or may interact with parts of your usual diabetes care regimen in ways that can’t be predicted by someone who doesn’t know you and your individual situation.
Your health-care provider will appreciate it if you evaluate the sites and the information you find on the Internet for quality before you bring it in to share with him. When you share it, tell your provider where you found it (the name or URL of the Web site) and why you feel it’s credible information (for example, because the publisher is well-known and reputable). Be sure that any printouts you make include the date or dates associated with the information. Together you can discuss whether and how this information might be beneficial to you.
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