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Accuracy of Medical Information on the Internet

The views expressed are those of the author and are not necessarily those of Scientific American.


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Portrait of Dr. Gachet, by Vincent van Gogh, public domain

Portrait of Dr. Gachet, by Vincent van Gogh, public domain

“We can just Google it!” is becoming our standard response to unanswered questions in life. Whether we are looking for the title of an irritating 80s song, a restaurant serving authentic Icelandic food or the quickest bus route to the Star Trek convention, the Internet usually offers the long-sought answers. However, when we enter key words in a search engine such as Google, we end up with thousands of websites – many of which are barely relevant to what we are looking for or are rife with inaccuracies.

Identifying the websites with the most accurate and relevant information are critical skills that are necessary for navigating our way in the digital information jungle, but unfortunately, these skills are rarely taught. In most cases, inaccurate or irrelevant information on the internet merely delays us for a few minutes until we do find the answer to what we are looking for. However, when it comes to medical information, inaccurate or irrelevant information could potentially have a major detrimental impact on our well-being.

Patients and their family members are increasingly using the internet as a major source of advice regarding their illnesses, treatment options, dietary advice and disease prevention. However, little is known about the accuracy of medical advice obtained via the internet. A study entitled “Safe Infant Sleep Recommendations on the Internet: Let’s Google It” by Dr. Rachel Moon and colleagues (published online in the Journal of Pediatrics on August 2, 2012) addresses this question by focusing on the question of sleep safety in infants. The American Academy of Pediatrics (AAP) has published guidelines for reducing the risk of sudden infant death syndrome (SIDS), suffocation or other accidental sleep-related infant deaths.

The Doctor Luke Fildes

The Doctor Luke Fildes

However, since such guidelines are written for clinical professionals, they often contain medical jargon that cannot be easily understood by concerned parents that want practical advice regarding how to ensure the sleep safety of their infants. Thus, instead of reading the AAP guidelines, most parents probably enter key phrases related to infant sleep safety into an internet search engine and may follow the advice displayed on the sites identified by the search engine.

Dr. Moon and colleagues tested the accuracy of such websites by entering thirteen search phrases such as ” Infant sleep position”, ” Infant co-sleeping” or ” Pacifier sleeping” into the Google search engine, and then cross-checked the medical information offered in the search results with the AAP recommendations, which was used as the standard for medical accuracy.

Since most parents would probably read the first few pages of the Google search results, the researchers only analyzed the first 100 websites identified by each of the thirteen Google searches (total of 1300 websites). Only 43.5% of these 1300 websites contained recommendations that were in line with the AAP recommendations, while 28.1% contained inaccurate information and 28.4% of the websites were not medically relevant. The accuracy was highly dependent on the type of question asked. The search phrase “infant cigarette smoking”, for example, yielded 82% accurate results, while the search phrase “infant home monitors” resulted in only 18% accuracy.

Of note, the researchers also categorized the results by the organization or group that had generated the website. Out of the 1300 websites identified by the searches, 246 (19%) were retail product review site websites and 250 (19%) were websites associated with specific companies or interest groups. Product review retail websites were also the ones which had the lowest level of medical accuracy (8.5%). On the other hand, government websites and websites of national organizations (as identified by URL ending in .org) had the highest level of accuracy (80.9% and 72.5%, respectively).

Google Girls, by Defluiter at Wikimedia Commons

Google Girls, by Defluiter at Wikimedia Commons

Surprisingly, educational websites (universities or other websites with URL’s ending in .edu, ebooks, peer-reviewed articles) only had 50.2% accurate medical information, possibly due to the fact that either some of the information was not updated or that a number of the linked articles required a subscription and thus could not be accessed. The majority of the books found by the search engine either provided outdated or irrelevant information, which may have also contributed to the low accuracy rate of educational websites. Blogs and websites of individuals also had very low rates of medical accuracy (25.7% and 30.3%).

This study highlights the opportunities and pitfalls of using the internet to communicate medical information. The internet is providing an opportunity for patients and family members to obtain additional medical information that they did not receive from their physicians, as well as to address questions that may arise and do not warrant a visit to a physician. On the other hand, the study also demonstrates that the quality of medical information on the internet varies widely. Searches for certain key phrases can unwittingly lead a user to websites that promote certain products or treatments without taking the medical evidence and professional guidelines into account.

One key factor to help address this pitfall is for physicians and other healthcare professionals to actively guide patients or family members to website that are likely to have information with high levels of medical accuracy. Instead of placing the burden of discriminating between accurate and inaccurate information on patients, healthcare professionals could advise patients or parents as to what websites should be used to address medical questions that they might have.

Furthermore, government institutions, organizations and educational websites need to realize the importance of maintaining up-to-date and accessible medical information on their websites. Concerted efforts between government or educational institutions, professional organizations and healthcare professionals are necessary so that patients can maximally benefit from the information opportunities afforded by the internet.

 

Jalees Rehman About the Author: Jalees Rehman, MD is a German scientist and physician. He is currently an Associate Professor of Medicine and Pharmacology at the University of Illinois at Chicago and a member of the University of Illinois Cancer Center. His laboratory studies the biology of cardiovascular stem and progenitor cells, with a focus on how cell metabolism may direct the differentiation and self-renewal of regenerative cells. He can be followed on Twitter: @jalees_rehman and contacted via email: jalees.rehman[at]gmail.com. He has a blog about stem cell biology at Scilogs called The Next Regeneration. Some of his other articles related to literature or philosophy can be found on his personal blog Fragments of Truth. Follow on Twitter @jalees_rehman.

The views expressed are those of the author and are not necessarily those of Scientific American.






Comments 9 Comments

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  1. 1. Bryllars 4:05 am 08/3/2012

    When I was first diagnosed the internet was young – and email groups were vibrant. The information there from patients and volunteer doctors who cared was incredibly helpful and useful and live discussion kept it in line.
    That was FAR better than the misleading information available on more official medical assoc and information websites. It is important to maintain that openness and guide people to it.

    Link to this
  2. 2. jalees 5:48 am 08/3/2012

    @Bryllars

    Thank you for bringing this up. The article in the Journal of Pediatrics discussed above shows that even organizational or government websites can contain inaccurate information, and that on the other hand, one can indeed occasionally find accurate information on individual blogs or interest group websites. Furthermore, the “gold standard” for accuracy were the guidelines of the American Academy of Pediatrics – not everyone may agree with this being the “gold standard” for accuracy.

    Especially proponents of alternative medicine or of novel experimental treatments may disagree with the guidelines of national organizations. These guidelines primarily rely on large-scale clinical trials. They tend to mostly recommend treatments or preventive strategies once there is sufficient data available – often years after these treatments have been introduced, because it takes many years to conduct studies and evaluate the research data. Even the guidelines are based on a consensus of medical experts and researchers and it is not unusual to meet professionals who disagree with some aspects of these guidelines.

    However, the problem with individual blogs and websites run by interest groups is that they often do not have a formal mechanism that critically evaluates the medical evidence before issuing a recommendation. Instead, the recommendations can be based on subjective experiences that may not apply to the broader population.

    Link to this
  3. 3. RockyBob 2:22 pm 08/4/2012

    Certainly there are really bad and questionable websites. What I find even more aggregious are websites that should have the highest standards that dispense incorrect info or fail to provide Important information. My personal example is the Harvard Medical newsletter. This website promotes articles and pamphlets with the appearance of the highest authority and they are often wrong. One publication, in particular, seemed so factually wrong that I emailed the author. I stated that I felt the document contained many serious errors and omissions and provided four examples from the first part of his document. Surprisingly, the MD author agreed about the errors and the omission but ignored the issue that there were more. He seemed surprised at the content omission, referring to “they left it out” which leads me to believe he never even authored his document. So far as I know, nothing was changed and people are still buying wrong information. Other HMC newsletter topics, especially in diet and nutrition, seem dangerously wrong. I wrote to Harvard medical ethics board, but of course they never responded.

    Link to this
  4. 4. LaMedBoheme73 5:29 pm 09/27/2012

    This is a great article with many relevant points and I am very happy to see it being addressed. In spite of that, one very important piece is missing in all of this – the medical librarian. Medical librarians are trained experts in vetting information (medical or other) and can assist anyone with finding information most pertinent to their question, clinical or not.

    Additionally, we all recommend that physicians direct their patients – and anyone who wants health information – to use Medlineplus.gov as the premiere resource in consumer health information. Medlineplus is maintained by the National Library of Medicine and contains information on nearly every medical condition, all written in easy to understand language.

    When you think medical information you should also think medical librarian.

    Respectfully,
    Heather N. Holmes, MLIS, AHIP

    Link to this
  5. 5. issuesresearch 10:04 pm 11/26/2012

    While we should undoubtedly exercise caution in trusting the accuracy of medical information on the Internet, we should also exercise appropriate caution in trusting the accuracy of medical guidelines. A recent study found that less than half of 130 clinical guidelines reviewed met more than half of the quality standards issued by the Institute of Medicine.

    Failure of Clinical Practice Guidelines to Meet Institute of Medicine Standards
    Justin Kung, MD et al
    Arch Intern Med. 2012;172(21):1628-1633
    http://archinte.jamanetwork.com/article.aspx?articleID=1384245

    Link to this
  6. 6. herryponting 1:18 am 12/18/2012

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    Patients and their family members are increasingly using the internet as a major source of advice regarding their illnesses, treatment options, dietary advice and disease prevention.

    Link to this
  7. 7. jastrass 11:49 am 03/20/2013

    Doctors are using the web more and more to start their diagnosis or in confirming the diagnosis they already have. For primary care doctors, thy see a rash or a lump and they use the web to see if other doctors had seen something similar and how their diagnosis held up.

    They use tools like http://www.consultant360.com/article/extrapulmonary-sarcoidosis on the peer reviewed The Consultant web site to see images and what others say about their diagnosis.

    Being able to more quickly diagnose is helping doctors see more patients and make more money in the long term.

    Jeff

    Link to this
  8. 8. SAltbier 3:21 pm 11/5/2013

    Dr. Jalees Rehman thoroughly addressed the problem of inaccurate medical information being published on the internet. I agree that the average person cannot tell the difference between an authoritative medical literature and inaccurate medical information published on the internet. Medical librarians and medical independent information professionals have access to authoritative medical literature databases. They can advise medical professionals and the general public about accurate medical information.
    Stephanie R. Altbier, CEO, Pinpoint Search Strategies LLC

    Link to this
  9. 9. Tanvirxseo 12:37 pm 09/27/2014

    Thank you very much for publishing this kind of article. I like your article very much. I want share my website details to you please give me some information to increase performance like as your website.
    Website: http://www.freemedicaljournals.com/

    Link to this

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