Online health information not always complete

Information consumers find on Web sites is generally accurate, but usually incomplete and hard for many readers to understand, according to a report featured in the Journal of the American Medical Association (vol. 285, no. 20).

The study, which was commissioned by the California HealthCare Foundation, Oakland, CA, and conducted by Santa Monica, CA-based RAND, evaluated the quality, accessibility and readability of the data on the Internet, and looked at both English- and Spanish-language Web sites and search engines. The research focused on information about four common medical conditions - breast cancer, childhood asthma, depression and obesity.

"We know that the Internet is revolutionizing the availability of health information for consumers," said Mark D. Smith, president and chief executive officer of the California HealthCare Foundation. "The study suggests that there are lots of good things going on, and also lots of room for improvement."

"The Internet is still in its formative stages and has tremendous potential as an information resource for patients and healthcare providers alike," said Gretchen Berland, the report's lead author. "This research provides guidance both on how to use what is available on the Internet now and on the changes needed to make the information better and more reliable."

Key findings

Working with nationally recognized clinical experts and patient advocates, the researchers established the basic elements of what consumers should know about each of the four conditions and compared those with the information on 18 English-language and seven Spanish-language sites. The study found that:

•Â On average, about 25% of those clinical elements were not covered at all by the English-language sites, and 53% were not covered by the Spanish-language Web sites.

•Â Less than half of the Spanish-language materials explained that mastectomy and lumpectomy plus radiation are equivalent treatments for early-stage breast cancer.

•Â One in five English-language sites provided complete and accurate information about managing the initial symptoms of a severe asthma episode.

•Â Although the accuracy of information presented was fairly high, many of the sites contained contradictory information.

•Â Conflicting information regarding depression most often concerned methods of treatment, while conflicting information pertaining to breast cancer concerned diagnosis.

Recommendations

In addition to the JAMA article, RAND and CHCF have released recommendations for consumers, consumer advocacy groups, healthcare providers, health Web sites and policy makers. Among the recommendations, consumers are advised to:

•Â Allow ample time to search for answers to their questions.

•Â Be aware that a single site will probably not provide a comprehensive picture of what they need to know about a condition. As many as four to six sites must often be visited.

•Â Discuss information they find onthe Internet with their healthcare provider before using it to make a treatment decision.

"This study establishes a benchmark against which to measure improvement," said Mark D. Smith, president and chief executive officer of the California HealthCare Foundation. "The findings provide a call for consumers to proceed with some caution when using the Internet, for healthcare providers to understand and consult with their patients about what they are reading online, and for e-health industry leaders to become more involved in monitoring content." PR