Get the Facts: Seeking Credibility & Accuracy

April 2007 – Vol. 11, No. 4

Editors: Janet M. Pollard, MPH; and Carol A. Rice, Ph.D., R.N.

“As health care consumers, we have a big job: We must decide which information is good based on common sense, sound judgment, and some general guidelines. That can be hard.”¹ There are many sources of credible health information from reliable sources; however, there are many sources of misleading, false, and even harmful health information, as well. The goal of this HealthHints issue is to provide tips on how to evaluate health and medical information you see and hear for credibility and accuracy.

Scientific Studies: Think Twice about Chasing the Latest Headline

“Sound health advice is generally based on a body of research, not a single study. Be wary of results claiming a ‘quick fix’ that depart from previous research and scientific beliefs. Keep in mind that science does not proceed by dramatic breakthroughs but by taking many small steps, slowly building towards a consensus. Furthermore, news stories about the latest scientific study, especially those on TV or radio, are often too brief to include important details that may apply to you or allow you to make an informed decision.”²

When we read or hear about a report on a “seemingly” scientific study, we need to have an ear/eye for details. The following questions from the National Cancer Institute³ can help you analyze health research:

Who is reporting the results? Is the newspaper, radio or TV station, or Internet site a reliable source of medical news? You might want to talk to your health care provider to help you judge the reliability of the source.
Was the study based in the laboratory, on animals, or on people? The results of research on people are more likely to be meaningful to you.
How large is the study? In general, when it comes to understanding medical risks, the larger the study the more valid the data will be for the general population.
Does it include people like you? Check to see if some of the people in the study were the same age, sex, ethnic background, income group as you and had the same health concerns.
Are the results presented in an easy-to-understand way? They should use absolute risk, relative risk, or some other easy-to-understand number. For an explanation of absolute and relative risk, see the following article on “Understanding Breast Cancer Risk”.⁴
Does the report clearly tell what behavior or medical treatment was studied? Information about the study should include this information. It should also include what outcomes, such as lower cancer risk or increased detection, were measured in the study.
What are other possible explanations for the study results? Researchers should discuss other possible explanations for the results, which may include other risk factors or problems with the research.
Where was the research done? Scientists at a medical school or large hospital, for example, might be better able to conduct complex experiments or have more experience.
Has the study been published in a peer-reviewed journal? Medical journals use a peer-review process to help ensure the quality of the research. (Peer review is an appraisal of research against accepted standards by professionals in the field.)³

Internet Information: Navigating the health information superhighway

“Millions of consumers are using the Internet to get health information.”⁵ “The Internet can be a mixed blessing when it comes to health care. We now have more health information at our fingertips than anyone dreamed possible just a few short years ago.

But how much of it can we trust? How can we tell the difference between good and bad health information, especially when there’s so much of it? This becomes a very important question when you consider that many people rely on the Internet to learn about illnesses or make decisions about care and treatment—sometimes for very serious conditions.

There are no rules policing the kind of health information that turns up on the Internet or who puts it there.”¹ It is up to the consumer to decipher the information as true or false. The following information can help you evaluate Internet health information for credibility and accuracy.

Find Out Who: Points to consider

Who runs the website? A good health website should make it easy to learn who is responsible for the site and its information. Information about who runs the site can often be found in an “About Us” or “About this Website” section, usually with a link on the site’s home page.⁵

Who pays for the site? Beware of bias. Check to see if the site is supported by public funds, donations, or by commercial advertising. Check to see that advertisements are labeled. They should say “Advertisement” or “From Our Sponsor.” Look at a page on the site and see if it is clear when content is coming from a non-commercial source and when an advertiser provides it. For example, if a page about treatment of depression recommends one drug by name, see if you can tell if the company that manufactures the drug provides that information. If it does, you should consult other sources to see what they say about the same drug.⁶

Find Out What: Points to consider

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 information will help you evaluate its purpose.⁵ Look for the “About Us” button or “Mission Statement.”⁶
If board members or authors are listed, look for information on them or their credentials. An advisory board composed of attorneys and accountants is not medically authoritative.⁶
Be cautious about sites trying to sell a product or service. Remember, quackery abounds on the Web. Remember the adage “If it sounds too good to be true, it probably is.” A health website for consumers should use simple language, not technical jargon. Get a second opinion. Check more than one site.⁵

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.

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 request may be made so they can collect a fee or select relevant information from the visitor. In all cases, the subscription or membership will allow the website owners to collect personal information about their visitors.

Any website asking users for personal information should explain exactly what the site will and will not do with the information. Look for a “Privacy Statement” or “Privacy Policy.” 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.^5,6

Find Out How: Points to consider

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).⁵

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.⁵

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.⁵

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 Website.”⁵

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. Look for a “Contact Us” button or page.⁵ If you have any doubts, try to actually contact the site administrator to see if there is an actual person you can reach or written feedback you can receive.

Check It Out: Think it through

Does the information check out? Compare the information you find on a site with other sites, news accounts, or library resources to see if it says the same thing. You can also get your doctor’s opinion by asking whether he or she is familiar with the information you uncovered.¹

Does the information tell you to do something? Be careful of any site that wants you to take action right now (buy something, send personal information or money). No matter how good a plan or remedy might seem, check the information out or talk to a doctor before acting on it.

Because health care issues can be complex, even medically reliable consumer information can be hard to understand at times. Look for sites that explain things clearly and completely. If you’re not sure you understand something you read, look for more information or ask your doctor or someone with health-care training to explain it to you. Misunderstanding health information can be dangerous.¹

Does the information sound too good to be true? Be on guard for misleading reports of medical information. Sometimes, reporters misrepresent study findings because they don’t understand them or because they’re trying to make a story more interesting. Shop around to see if other sources support the information you have. Check for links. Reliable sites are more likely to link to others with similar information. Beware of sites that link only to a search engine. Remember, if the information sounds unbelievable, it probably is. Some websites push miracle cures for cancer and other diseases without enough evidence or studies to show they work.¹ For information on fraudulent activity on the Internet and elsewhere, see the fact sheet “Protecting and Promoting Human Health” (PDF).

Can the accuracy of information received in an e-mail be verified? Carefully evaluate e-mail messages. Consider the origin of the message and its purpose. Some companies or organizations use e-mail 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.⁵

Chat Rooms & Discussion Groups: Participate or not?

Is the information that’s discussed in chat rooms accurate? How do you know?

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.⁵

Health sites with discussion boards and chat rooms allow Internet users to support one another and share health information and experiences. Some chats feature medical experts who answer consumer questions online.¹

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.⁵

Whether you’re seeking further information for a medical treatment or trying to improve your health to meet your own personal goals, be careful as you seek out information. Use the ideas in this newsletter as you evaluate the accuracy and credibility of any source…and, if in doubt, always consult with a health care professional. Remember, information you read in a journal, magazine, newspaper, or on the Internet is not meant as a substitute for medical advice or care from a qualified health professional. If you do not feel you are receiving appropriate advice or care, seek out a second opinion from a qualified provider. Remember, you are your own health care consumer—be the best one you can be by having an ear and eye for good advice and good care.

Discussion Groups, Chat Rooms, & Your Doctor

While information you get from discussion groups and chat rooms can be helpful, they shouldn’t be the basis for making decisions about your care. In fact, no health information you find on the Internet should replace a doctor’s medical advice. Instead, it should help you learn about your problem and treatment options so you can work better with your doctor to get the best care possible.¹

If you’re looking for information online because you don’t like or believe what your doctor has told you, get a second opinion, or share what you learned with your doctor. If your doctor won’t discuss information you gathered, you might need to find one who will.¹

Good Sources of Health Information...

Sites that end in “.gov,” are sponsored by the federal government, like the U.S. Department of Health and Human Services (www.hhs.gov), the Food and Drug Administration (www.fda.gov), the National Institutes of Health (www.nih.gov), the Centers for Disease Control and Prevention (www.cdc.gov), and the National Library of Medicine (www.nlm.nih.gov). (For a listing of some reputable websites, see the fact sheet, “Help for Finding the Information You Need” [PDF].)
.edu sites are run by universities or medical schools, such as Johns Hopkins University School of Medicine and the University of California at Berkeley Hospital, health systems, and other health care facility sites, like the Mayo Clinic and Cleveland Clinic.
.org sites are 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, are not written for consumers and can be hard to understand, but they contain reliable information.
Sites whose addresses end in .com are usually commercial sites and are often selling products.⁵

References:

American Association of Retired Persons (2007). Checkups and prevention: finding health information online. Retrieved February 20, 2007. From http://www.aarp.org/health/staying_healthy/prevention/
a2003-03-17-wwwhealth.html
U.S. Food and Drug Administration (2005). Tips for the savvy supplement user. Retrieved February 20, 2007. From http://www.cfsan.fda.gov/%20~dms/ds-savvy.html#resources
National Cancer Institute (2007). Analyze the media. Retrieved February 23, 2007. From http://understandingrisk.cancer.gov/media/tool_02-01.cfm.
Breastcancer.org (2006). Understanding breast cancer risk. Retrieved March 6, 2007. From http://www.breastcancer.org/nav_about.html.
U.S. Food and Drug Administration (2005). How to evaluate health information on the internet. Retrieved February 20, 2007. From http://www.fda.gov/oc/opacom/evalhealthinfo.html.
U.S. National Library of Medicine (2006). MedlinePlus guide to healthy web surfing. Retrieved February 19, 2007. From http://www.nlm.nih.gov/medlineplus/healthywebsurfing.html.
U.S. Postal Inspection Service (2007). Mail fraud. Retrieved March 2, 2007. From http://www.usps.com/postalinspectors/fraud/.
Health Canada (2005). Trilateral cooperation. Retrieved February 20, 2007. From http://www.hc-sc.gc.ca/fn-an/intactivit/trilateral-coop/index_e.html.
Federal Trade Commission (2005). Say au revoir to diet ripoffs. Retrieved February 20, 2007. From http://www.ftc.gov/opa/2005/09/fatfoeci.htm.