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Finding Reliable Health Information Online

Develop your E-Health Literacy Skills

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The Internet has unlocked a vast world of information for everyone, information on any imaginable subject that is easily accessible 24 ⁄ 7 across the globe.

In the field of health and medical information, this is beneficial because it empowers individuals, helps spread knowledge, builds awareness, and improves the health literacy of the general public.

The downside of online health information is its quality. E-health websites provide content that ranges from excellent to superficial and unsubstantiated, from thoroughly researched and evidence-based to covert advertising, misinformation, or even blatant disinformation.

Beware of the Quackery and Fake News Online.

Risks of Unaccredited Health Websites

The dangers posed by substandard online health content are evident:

  • Risk of serious harm, including death: The information obtained on the web about a given health condition may be inaccurate or misleading and patients using it for self-diagnosis may decide to avoid or delay proper medical treatment, further worsening their health problems. This can lead to life-threatening situations.
  • Privacy concerns: These websites may also harvest personal information with login requirements or subscriptions to access specific content. This data can be paired with the medical information and browsing history of the subscribers, and sold to third parties. This raises serious confidentiality and privacy concerns.
  • Quackery: sites designed for the promotion and online sale of esoteric health practices, alternative medicines, and bogus medical treatments which at best have no therapeutic value and at worst can cause harm.
  • Overconsumption: A study by Bessière et al. (2012) found that "using the Internet for health purposes was associated with increased depression [which] may be due to increased rumination, unnecessary alarm, or over-attention to health problems" (1).
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Internet Health Literacy

The ability to seek, find, understand, and appraise health information from electronic sources and apply the knowledge gained to addressing or solving a health problem. Norman & Skinner, 2006

Interpreting health information in a useful way requires "Health Literacy" skills. It has been defined by the World Health Organization (WHO) as "The ability of individuals to gain access to, understand and use information in ways which promote and maintain good health" (2).

In the Internet era, this ability has evolved into "E-Health literacy" which involves a wide set of skills and not only the ability to read and understand a written text or an image. Norman and Skinner mention several, from which we highlight these (3).

  • Know which resources or websites will help find the information (not just google something and click on the first three search results).
  • Understand the health information itself, sorting through the concepts, and clarifying the obscure language to gain full comprehension of the subject.
  • Possess science literacy to give context to the information, learn about its limitations, look at it with a critical eye to understand any possible causes of controversy, and weigh the consistency of the explanations that are given.

But not everyone has these skills, so how can readers judge the trustworthiness of health information websites?

Finding Reliable Sources of Online Health Information

Diomma Dramé health researcher and journalist suggests that readers should use critical thinking to question the information, its sources, and the identity of its authors; in other words, fact-checking is crucial (4).

Quick Check List

This simple fact sheet can help you understand more about the reliability of a website ( 5, 6,7):

  1. Who operates the website? Does it provide clear information on the person or company, their address, phone, and e-mail?
  2. How is it funded? Is it a university (.edu), not-for-profit organization (.org), government site (.gov)? Or does it sell sponsored products, paid reviews, health care related services? The source of revenue may affect how news and information are presented to its visitors.
  3. What is its purpose? Read its "About Us" page, this will help you learn more about it.
  4. What is the source of its information? The original source of all information should be clearly stated (Researchers, studies, articles published in reputable peer-reviewed journals, etc) and cited. This is proof of the validity of scientific evidence. Testimonial and anecdotal evidence is unreliable and cannot be validated by scientific methods, they should be clearly labeled as such.
  5. Who reviewed the information before it was published? The credentials of those who prepared or reviewed articles published on the website should be provided.
  6. Is the information updated? The information should be kept current, and updated with new information or reviewed to ensure its content is still valid. The review date should be posted.
  7. What information does the website collect from its visitors? Does it require subscription, membership, or logging in? This will surely require that visitors disclose their e-mail, name, and other personal information. Why is this information collected? How are its confidentiality and safety ensured? Is it shared with others?
  8. How does it handle feedback? Can the owner be reached easily for feedback, comments, questions?

This should help you classify a website. You should compare information, benchmarking it with that published on other reputable websites.

Fake or True? Identifying Fake News

Misinformation according to Swire-Thompson & Lazer (2020)(8) is information that goes against the accepted "consensus of the scientific community". For instance stating that the measles, mumps, and rubella (MMR) vaccine causes autism is contrary to what is scientifically considered as valid, and therefore "misinformation".

Since advances due to paradigm shifts and new discoveries consensus changes to adapt to the new evidence. So published information must be reviewed periodically to keep abreast of the change in consensus.

Disinformation on the other hand is to deliberately publish and circulate misinformation in the pursuit of power, prestige, personal recognition, and monetary gain.

An example of this is the false claim linking radio waves emitted by 5G mobile phone towers to COVID-19.

Signs of False News

The Union for International Cancer Control recommends being aware of the following red flags which may indicate false news (9):

  • Texts that are poorly written
  • Sensational headlines followed by low-quality clickbait stories
  • Extremely high level of certainty in the advice given.
  • News that is startling or even disturbing.

Ask yourself: Do they want to influence me? Why was this article written? Who else reported about this? Check the facts, the sources. Fake news will not be able to pass this kind of test.

Advertising posing as Genuine Information

The NIH reveals some signs to look out for to find out if a website is fake:

  • It endorses a product or service. Legitimate news does not endorse products.
  • It only has positive, raving reviews about the product.
  • The content seems too good to be true.
  • It links to online merchant sites and none of its links back up its far fetched claims with legitimate research sites.
  • No comments can be added, but it has plenty of good testimonials and anecdotal comments by other "readers".
  • Advertising is evident but not identified as such, as required by the Federal Trade Commission's guidelines.

What can Reputable Websites Do?

Currently, it is up to the individual readers to evaluate the websites, judge their content, and maintain a critical attitude regarding the information they provide.

And even so, a study by Quinn, Bond, and Nunget (2017) found that 96% of individuals used "unaccredited" online sources (such as blogs) to search for health information (10).

This means that website owners and publishers have to take action proactively and there are several opportunities available to do so (3,8):

  • Create user-friendly websites, with a clear layout, breadcrumb links to assist in site navigation, sitemaps, and a logical structure and consistency across all web pages.
  • Create more relevant content, with links to the original sources and to further reading for those who want to probe deeper into a subject.
  • Consider the E-Health literacy skills of the general public, to assist them in finding the information that they are searching for.
  • Highly scientific content may be beyond the grasp of the average reader: content can be reliable, scientific, and also easy to understand and captivating.
  • Journalists should bridge the gap between scientists and the public and present new research and discoveries in ways that are accessible to the general public but this should be done without generalizing or oversimplifying them in such a way that it distorts or blurs the original information.
  • Use clear meanings, clarify difficult concepts, don't take for granted that the layperson understands scientific terms (DNA, T-cell, lipid, adipose, etc.), provide definitions, a glossary, explain clearly.
  • Science is meant to be fun! avoid jargon and long, complex sentences. Explain concepts using visual data such as charts, images, tables, infographics, or videos. Use clear, vivid, and accurate language.
  • Put things in perspective: use metric and US/Imperial units -not all of your readers live in the US. Simplify: explain what 5 x 10-9 means (do you expect readers to understand exponential notation?).
  • React to feedback and comments from your audience. Adapt the website to improve its usability.

Take-Home Points

Use your common sense, experience, and critical thinking when seeking health-related information online.

Learn how to identify reputable websites, validate their content, corroborate it by visiting other reliable online information sites.

Build your skills with practice. Bookmark the trustworthy sites in your browser.

And remember: online information is just that, information. It does not replace medical advice given by a qualified medical provider to meet your medical needs.

References and Further Reading

(1) Bessière K, Pressman S, Kiesler S, Kraut R. (2010). Effects of internet use on health and depression: a longitudinal study. Journal of medical Internet research, 12(1), e6.

(2) WHO The mandate for health literacy - Defining health literacy

(3) Norman CD, Skinner HA eHealth Literacy: Essential Skills for Consumer Health in a Networked World, J Med Internet Res 2006;8(2):e9 DOI: 10.2196/jmir.8.2.e9

(4) Diomma Dramé (2020). The health crisis: Fertile ground for disinformation

(5) U.S. Department of Health & Human Services, National Institutes of Health, How To Evaluate Health Information on the Internet: Questions and Answers

(6) The State of Victoria and the Department of Health & Human Services, Australia (2015) Finding reliable health information

(7) GOSH NHS Foundation Trust, UK (2014) Finding reliable health information on the Internet

(8) Swire-Thompson B and Lazer D. (2020). Public Health and Online Misinformation: Challenges and Recommendations, Annual Review of Public Health Vol. 41:433-451 (publ. April 2020)

(9) Union for International Cancer Control, 1 April 2020 Fake news: a threat to public health

(10) Quinn S, Bond R, Nugent C. (2017). Quantifying health literacy and eHealth literacy using existing instruments and browser-based software for tracking online health information seeking behavior. Comput. Hum. Behav. 69:256-67

About this Article

Finding Reliable Health Information Online, A. Whittall

©2020, 28 Aug. 2020.

Tags: Trustworthy health information, Reliable information, health, health news, information, Health Literacy, E-Health Literacy

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Subject: Finding Reliable Health Information online. Tips and suggestions on how to find trustworthy health-related information on the Internet.

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