PubMed · 10238161
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J F Ryan, F A Schwarzkopf. Patient simulating device.. https://pubmed.ncbi.nlm.nih.gov/10238161/
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OBJECTIVE: This study updates work published in 1998, which found that of 47 rating instruments appearing on websites offering health information, 14 described how they were developed, five provided instructions for use, and none reported the interobserver reliability and construct validity of the measurements. DESIGN: All rating instrument sites noted in the original study were visited to ascertain whether they were still operating. New rating instruments were identified by duplicating and enhancing the comprehensive search of the internet and the medical and information science literature used in the previous study. Eligible instruments were evaluated as in the original study. RESULTS: 98 instruments used to assess the quality of websites in the past five years were identified. Many of the rating instruments identified in the original study were no longer available. Of 51 newly identified rating instruments, only five provided some information by which they could be evaluated. As with the six sites identified in the original study that remained available, none of these five instruments seemed to have been validated. CONCLUSIONS: Many incompletely developed rating instruments continue to appear on websites providing health information, even when the organisations that gave rise to those instruments no longer exist. Many researchers, organisations, and website developers are exploring alternative ways of helping people to find and use high quality information available on the internet. Whether they are needed or sustainable and whether they make a difference remain to be shown.
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The currently prevailing paradigms of evaluation in medical/health informatics are reviewed. Some problems with application of the objectivist approach to the evaluation of real-rather than simulated-(health) information systems are identified. The rigorous application of the objectivist approach, which was developed for laboratory experiments, is difficult to adapt to the evaluation of information systems in a practical real-world environment because such systems tend to be complex, changing rapidly over time, and often existing in a variety of variants. Practical and epistemological reasons for the consequent shortcomings of the objectivist approach are detailed. It is argued that insistence on the application of the objectivist principles to real information systems may hamper rather than advance insights and progress because of this. Alternatives in the form of the subjectivist approach and extensions to both the objectivist and subjectivist approaches that circumvent the identified problems are summarized. The need to include systems engineering approaches in, and to further extend, the evaluation methodology is pointed out.