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PubMedDate not supplied

Web sites for postpartum depression: convenient, frustrating, incomplete, and misleading.

PURPOSE: To evaluate the content and the technology of Web sites providing information on postpartum depression. STUDY DESIGN AND METHODS: Eleven search engines were queried using the words "Postpartum Depression." The top 10 sites in each search engine were evaluated for correct content and technology using the Web Depression Tool, based on the Technology Assessment Model. RESULTS: Of the 36 unique Web sites located, 34 were available to review. Only five Web sites provided >75% correct responses to questions that summarized the current state of the science for postpartum depression. Eleven of the Web sites contained little or no useful information about postpartum depression, despite being among the first 10 Web sites listed by the search engine. Some Web sites contained possibly harmful suggestions for treatment of postpartum depression. In addition, there are many problems with the technology of Web sites providing information on postpartum depression. CLINICAL IMPLICATIONS: A better Web site for postpartum depression is necessary if we are to meet the needs of consumers for accurate and current information using technology that enhances learning. Since patient education is a core competency for nurses, it is essential that nurses understand how their patients are using the World Wide Web for learning and how we can assist our patients to find appropriate sites containing correct information.

Databases, Bibliographic↗

PubMed2000

Quality of information on female sterilisation on the Internet.

The Internet has a great potential to provide useful as well as useless or misleading information. To assess the quality of information available on-line on female sterilisation, we performed a search of the Internet using seven search engines. We set out to assess the first 10 sites found by each of the most frequently used search engines. Our search revealed 12 relevant Web sites, none of which complied with all of the criteria for quality. Our assessment focused on credibility and content of each Web site. Credibility was assessed by source which was described in nine Web sites, currency in five sites and review process in none. We assessed the content by hierarchy and accuracy of evidence which was fulfilled by five sites and one site respectively. This makes it difficult for a lay person to assess which Web sites provide accurate and useful information and which do not.

Journal Article↗

PubMed1997

Health On the Net automated database of health and medical information.

With the number of World Wide Web sites growing every day, the problem is not just to find information, but to locate the right piece of information. Current World Wide Web search engines have not resolved this problem as they most often return a long list of documents. The search result is then unusable because of the large number of answers from different domains and topics. Only complex queries may, in a given situation, produce a limited number of potentially relevant documents. To make searches more efficient and usable by common users, we now need intelligent and specialised search engines on the Net [1,2]. Health On the Net Foundation and the Molecular Imaging and Bioinformatics Laboratory at Geneva University Hospital have developed Multi-Agent Retrieval Vagabond on Information Networks (MARVIN), a robot that searches sites and documents specifically related to a given specialised field. One such robot has already been implemented and used for the medical and the 2D electrophoresis domains. Health On the Net Foundation has implemented the corresponding search engines, MedHunt (http://www.hon.ch/cgi-bin/find) for the medical field and 2DHunt (http://www.hon.ch/cgi-bin/2DHunt/find) for the 2D electrophoresis field.

Computer Communication Networks↗

PubMed2003

Forensic web watch--medicolegal aspects of paediatric pathology.

The trials over the deaths of Matthew Eappen and Victoria Climbie have highlighted the importance of forensic evidence in cases of suspected child abuse. The debate as to whether bruises, fractures or head injuries have been sustained as a result of previous trauma or non-accidental injury is central to these, and other, cases. A variety of subjects are encountered in forensic paediatric pathology, including Shaken Baby Syndrome, non-accidental injury, retinal haemorrhage, skeletal injury, Sudden Infant Death, sexual abuse and Munchausen Syndrome by Proxy. The coverage of these areas on the internet was assessed using two search engines (Google and the meta-search engine Mamma) and revealed patchy coverage. The majority of sites uncovered were, unsurprisingly, aimed at the layperson concerned by such issues; however, several sites containing useful information for the professional are available.

Journal Article↗

PubMedDate not supplied

Evaluation of the usefulness of Internet searches to identify unpublished clinical trials for systematic reviews.

PRIMARY OBJECTIVE: To avoid selection and publication bias, systematic reviewers should employ a broad range of search techniques and make efforts to locate unpublished studies. We tried to establish whether searches on the World Wide Web (WWW) are useful to identify additional unpublished and ongoing clinical trials. RESEARCH DESIGN: Search strategies seven Cochrane systematic reviews were retrospectively adapted for the WWW in an attempt to find additional randomized controlled trials. METHODS AND PROCEDURES: A search strategy with the general pattern 'study methodology NEAR intervention NEAR condition' for the Internet search engine AltaVista was evaluated by measuring search time, recall of Internet searches for published studies; precision (proportion of webpages containing hints to relevant published and unpublished randomized clinical trials); number of additional unpublished or ongoing studies found on the Internet. MAIN OUTCOMES AND RESULTS: We reviewed 429 webpages in 21 hours and found hints to 14 unpublished, ongoing or recently finished trials, at least 9 were considered relevant for 4 systematic reviews. The recall of Internet searches to find references to published studies ranged between 0% and 43.6%, the precision for hints to published or unpublished studies range between 0% and 20.2%. CONCLUSIONS: Information on unpublished and particularly ongoing trials can be found on the Internet. A potential problem is the appraisal of non-peer reviewed electronic publications with questionable quality. More powerful search tools are needed. An 'Open Trial Initiative' is proposed to define a syntax for publishing trials on the web and to ensure interoperability of trial registers, so that special search engines can harvest information on ongoing and complete clinical trials.

Data Collection↗

PubMed2002

Evaluating the quality of internet-based information about alternative therapies: development of the BIOME guidelines.

BACKGROUND: The aim of the study was to develop guidelines for evaluating the quality of Internet-based information about alternative therapies. METHOD: An expert committee drafted a set of guidelines for evaluating information relating to alternative therapies. The guidelines were subsequently refined by testing them using resources already included in the BIOME databases. The first 20 unique web sites about alternative therapies for cancer retrieved using a general search engine and a United Kingdom focused search engine were then evaluated using the refined guidelines. Those undertaking the evaluations also completed a questionnaire relating to the face and content validity of the guidelines. The participants in the implementation stage were six content providers. Content providers identify, evaluate and describe resources for inclusion in the BIOME databases. RESULTS: Only one web site out of 20 was selected by all six content providers for inclusion in the BIOME databases according to the alternative therapies guidelines. All content providers were in agreement regarding the exclusion of nine sites, but there were discrepancies regarding the remaining 10 resources. There was general agreement that the guidelines were easy to understand and that all points raised were necessary. However, there were differences of opinion regarding whether all issues were covered, whether the guidelines allowed the selection of only the highest quality resources, and whether the guidelines were applicable to a wide range of Internet-based resources about alternative therapies. CONCLUSIONS: The levels of inconsistencies in the results indicate the need for the further development of the BIOME guidelines for selecting information about alternative therapies.

Complementary Therapies↗

PubMed2004

The quality of patient-orientated internet information on colorectal cancer.

OBJECTIVE: The Internet provides an enormous amount of patient-orientated information on colorectal cancer. This study examined its accessibility and quality. METHODS: Sites were identified using two search engines (Google and Hotbot) and the search terms 'bowel cancer' and 'colon and rectal cancer'. The first 100 sites in each search were visited and classified. Sites that contained patient information were assessed using the 'Discern' instrument for reliability and quality of information on treatment choices. RESULTS: Google identified 55,700 sites for the search term 'colorectal cancer' and 214,000 for 'bowel cancer'. Hotbot produced 27,700 and 190,000, respectively. Four hundred sites were studied. Only 25 (6%) sites were duplicated in the searches. One hundred and eighteen (30%) provided information, 70 (18%) were lists of links, 27 (7%) were adverts, 22 (6%) promoted medical centres, 51 (13%) were dead links, 15 (4%) were message boards. Of the 118 that provided information 73 (62%) advised on treatment and 73 (62%) were designed for patients. The sources of information were clear in 55 (47%) and the date when this information was reported was given in only 63 (53%). By adapting the Discern instrument, sites were classified as excellent 18 (15.3%), very good 19 (16.1%), good 28 (23.7%), fair 8 (6.8%) and poor 45 (38.1%). CONCLUSIONS: The Internet provides a wealth of information on colorectal cancer but the best sites are difficult for patients to distinguish from the thousands of sites returned by search engines. Clinicians should guide patients to quality sites to avoid confusion and misinformation.

Colorectal Neoplasms↗

PubMed2004

Setting the public agenda for online health search: a white paper and action agenda.

BACKGROUND: Searches for health information are among the most common reasons that consumers use the Internet. Both consumers and quality experts have raised concerns about the quality of information on the Web and the ability of consumers to find accurate information that meets their needs. OBJECTIVE: To produce a national stakeholder-driven agenda for research, technical improvements, and education that will improve the results of consumer searches for health information on the Internet. METHODS: URAC, a national accreditation organization, and Consumer WebWatch (CWW), a project of Consumers Union (a consumer advocacy organization), conducted a review of factors influencing the results of online health searches. The organizations convened two stakeholder groups of consumers, quality experts, search engine experts, researchers, health-care providers, informatics specialists, and others. Meeting participants reviewed existing information and developed recommendations for improving the results of online consumer searches for health information. Participants were not asked to vote on or endorse the recommendations. Our working definition of a quality Web site was one that contained accurate, reliable, and complete information. RESULTS: The Internet has greatly improved access to health information for consumers. There is great variation in how consumers seek information via the Internet, and in how successful they are in searching for health information. Further, there is variation among Web sites, both in quality and accessibility. Many Web site features affect the capability of search engines to find and index them. CONCLUSIONS: Research is needed to define quality elements of Web sites that could be retrieved by search engines and understand how to meet the needs of different types of searchers. Technological research should seek to develop more sophisticated approaches for tagging information, and to develop searches that "learn" from consumer behavior. Finally, education initiatives are needed to help consumers search more effectively and to help them critically evaluate the information they find.

Community Participation↗

PubMed2000

Tracing medical information over the Internet.

The Internet became with do doubt a huge and valuable source of information for researchers. The wealth of information on the Internet is second to none and medical information is no exception. Yet with the vast expansion of the Internet and the World Wide Web in specie, to find the kind of information one is looking for, he/she needs to browse thousands of web sites and the experience would be like digging into a stack of hay looking for a needle. That's why search engines and subject indexes, as means to overcome this problem, were introduced and grew so rapidly. In general, there are three approaches to retrieve data from the World Wide Web; the subject directories, search engines and detailed subject indexes. However, there is no single comprehensive search engine or directory and it is recommended to use more than one with different keywords and synonymous.

Abstracting and Indexing↗

PubMed2002

Melanoma information on the Internet: often incomplete--a public health opportunity?

PURPOSE: To assess the accuracy and completeness of information regarding melanoma on the Internet, retrieved by use of search engines. METHODS: The first 30 uniform/universal resource locators (URLs) from each of eight search engines using the search term "melanoma" were retrieved for evaluation of accuracy and completeness using a 35-point checklist rating system instrument. Four reviewers independently rated each of 35 sites, and one reviewer rated all 74 assessable sites. Kappa statistics were used to evaluate interrater variability. RESULTS: A total of 74 assessable Web sites were evaluated. The remainder were inaccessible, link pages only, or duplicates. Thirty-five Web sites were each independently rated by four reviewers. The remaining 39 Web sites were each rated by one reviewer. The mean kappa statistic for all variables and all rater pairs for which a kappa could be calculated was 0.824, indicating excellent overall inter-rater reliability. The majority of Web sites failed to include complete information on general information, risk factors, diagnosis, treatment, prevention, and prognosis. Ten Web sites (14%) contained a total of 13 inaccuracies, most relatively minor. CONCLUSION: Medical information retrieved with the search term melanoma was likely to lack complete basic melanoma information and contained inaccuracies in 14% of sites. Health care providers can help patients by recommending comprehensive and accurate Web sites for patient review, by working to create accurate and thorough Web-based health information material, and by educating patients and the public about the variability in completeness and accuracy.

Humans↗

PubMed2000

Accessibility and reliability of cutaneous laser surgery information on the World Wide Web.

The World Wide Web has provided the public with easy and affordable access to a vast range of information. However, claims may be unsubstantiated and misleading. The purpose of this study was to use cutaneous laser surgery as a model to assess the availability and reliability of Web sites and to evaluate this resource for the quality of patient and provider education. Three commercial methods of searching the Internet were used, identifying nearly 500,000 possible sites. The first 100 sites listed by each search engine (a total of 300 sites) were compared. Of these, 126 were listed repeatedly within a given retrieval method, whereas only 3 sites were identified by all 3 search engines. After elimination of duplicates, 40 sites were evaluated for content and currency of information. The most common features included postoperative care suggestions, options for pain management or anesthesia, a description of the way in which lasers work, and the types of lasers used for different procedures. Potential contraindications to laser procedures were described on fewer than 30% of the sites reviewed. None of the sites contained substantiation of claims or referrals to peer-reviewed publications or research. Because of duplication and the prioritization systems of search engines, the ease of finding sites did not correlate with the quality of the site's content. Our findings show that advertisements for services exceed useful information.

Humans↗

PubMed1999

A critical appraisal of the use of Internet for calculating cardiovascular risk.

This paper aims to retrieve and evaluate the quality of the Internet sites providing information on cardiovascular risk. We searched web pages related to risk prediction using six search engines. Sites proposing a cardiovascular risk prediction were selected for evaluation. The quality of each site was checked against criteria testing the validity, type and potential usefulness of information for physicians or patients. Search engines retrieved about 50 10(6) web pages. Eight sites were included. Only 2 of them provided calculation of cardiovascular risk based on Framingham equation. The others proposed algorithms, guidelines, or general information on cardiovascular health. Most sites lacked details to ensure quality of information. Present search engines are inefficient to retrieve precise and valid information. Facing the inflation of medical information, a systematic approach to validate the quality of a site is mandatory. Application of Evidence Based Medicine concepts gives a solution for evaluation of internet-based medical information.

Cardiovascular Diseases↗

PubMed2003

Information contained in miscarriage-related websites and the predictive value of website scoring systems.

OBJECTIVES: To identify websites providing information about early pregnancy loss and compare this information with published guidelines from the Royal College of Obstetricians and Gynaecologists (RCOG). The value of 'Silberg' and 'Health on the net (HON)' website scoring systems in predicting the information provided via websites identified was assessed. STUDY DESIGN: A cross-sectional survey. SAMPLE: Nineteen websites identified via two search engines (http://www.lycos.co.uk and http://www.msn.co.uk). METHODS: Websites were searched for specific information in a structured manner and then scored by two independent observers against the website scoring systems and against a scoring system derived from guidelines published by the RCOG. MAIN OUTCOME MEASURES: Website scores against the scoring systems and against RCOG guidelines. RESULTS: Information concerning miscarriage contained within these websites was poor and scored accordingly against the RCOG guidelines (median score, 4.5/8). The website scoring systems did not predict the RCOG scores for a website (HON score R(S)=0.193 (95% confidence interval from -0.286 to 0.595), Silberg score, R(S)=0.035 (95% confidence interval from -0.426 to 0.482)). CONCLUSIONS: Few relevant websites were identified despite searching a large number via two search engines. The websites found did not answer our specific questions and consequently scored poorly against the RCOG guidelines. RCOG scores did not correlate with either scoring system. Web-based information for women attending with early pregnancy complications needs to be easily accessed and comprehensive. Written information given to women when seen with early pregnancy complications should include details of available comprehensive websites. Professional organisations, colleges or Government agencies should provide this type of information.

Abortion, Spontaneous↗

PubMed1999

Digestive disease resources on the Internet.

The aim of this study is to help digestive disease professionals fully utilize the resources available on the Internet for patient care, education, and research. The following search resources were employed to locate websites: general search engines--Lycos, Metacrawler, Webcrawler, and Yahoo!; medical search engines--HealthWeb, MedMatrix, MedWeb, and MedWebPlus; website links; and publications. The inclusion of web sites was based on their content. Each site was evaluated with respect to its authorship, attribution, currency, and disclosure. All digestive disease professional organizations and academic centers that met the above criteria were included. Only nutrition sites with relevance to digestive diseases were included. A variety of very useful web sites related to digestive diseases exist on the Internet, and their numbers are growing. Many of these sites have valuable information that can be used to improve patient care, promote medical education, and facilitate research. Digestive disease professionals should adopt the Internet and address the many issues raised by this technology.

Digestive System Diseases↗

PubMed2006

A review of the non-Alzheimer dementias.

OBJECTIVE: To review the clinical features, neuropathologic features, clinical course, differential diagnosis, evaluation, and management strategies of the primary non-Alzheimer degenerative and prion disorders that cause dementia. DATA SOURCES: The PubMed MEDLINE search engine was used to query for all published articles written in English from January 1990 to August 2005 using the keywords non-Alzheimer, tau, tauopathy, synuclein, synucleinopathy, prion, cognitive impairment, and dementia syndrome. These and related terms were queried on the following additional search engines: On-Line Mendelian Inheritance in Man and GeneTests. Reputable organizations whose aims include promoting education and research in specific syndromes and disorders were queried using the search engine Google. STUDY SELECTION: The original articles on the disorders and syndromes, and subsequent articles and consensus papers that discussed in detail the clinical features, pathologic features, differential diagnosis, evaluation, management strategies, or some combination thereof, were selected for this review. DATA EXTRACTION: Data were extracted from articles that include generally accepted concepts and guidelines on the non-Alzheimer degenerative and prion disorders as viewed by the author. DATA SYNTHESIS: The following data were synthesized and emphasized: the cardinal clinical features, differential diagnosis, findings on ancillary studies most helpful in establishing accurate diagnoses, diagnostic criteria, and key principles of management. CONCLUSIONS: This article provides an up-to-date overview of the primary non-Alzheimer disorders that cause cognitive impairment/dementia to aid the clinician in establishing diagnoses and deciding on appropriate management.

Dementia↗

PubMed2000

Forensic web watch 3.

Since the publication of the first 'Forensic Web Watch' article a new search engine has become available, free of charge at the time of writing, to surfers of the Internet (Net). Fast Search claims to seek out sites of interest for the user from 'all the Web, all the time trade mark ' as opposed to parts of the Net as is more common with other search machines. It is easy to use, extremely fast but as it searches so much more of the Net, the end result is considerably larger. This, in turn, may lead to a longer time to seek out useful information as opposed to the obscure. Having said this, it is recommended to add to your search engine bookmarks. A search for sites on issues related to 'Police Surgeons' will yield limited information, as each country will have a different person filling this role, all referred to by different terms. The one common feature, however, to all such groups as well as forensic pathologists and scientists, is that they will work with, or in some cases for, the police services of their respective country. Thus, in this article we will look at sites related to the police which may have useful information related to their work, specific cases of interest and research and development which may effect our practice.

Journal Article↗

PubMed2006

Information on the Internet about head injury pertaining to intensive care: less quantity and more quality is needed.

OBJECTIVE: Published data suggest that the quality of information on diseases accessible on the Internet using non-medical search engines is poor. Such data do not exist for illnesses requiring intensive care. This study investigated the accuracy of health information about head injury pertaining to intensive care on the Internet, and correlated website characteristics with the quality of their content. METHODS: A cross-sectional survey was conducted of the first 20 websites retrieved by the seven most frequently used search engines, with the information evaluated by two independent observers. Inter-observer reliability was evaluated using the kappa statistic. Website information on head injury was compared with "gold standard" guidelines from the Brain Trauma Foundation. Website characteristics were assessed, and their correlation with quality of website content was analysed. RESULTS: 58 websites were assessed. Weighted kappa for interobserver agreement on quality scores was 0.72. The median content score was 2 (interquartile range, 0-4) out of a possible maximum of 23. Logistic regression analysis suggested that medical authors, government sponsors, and being in the second 10 websites retrieved by a search engine were associated with higher website quality scores, while financial incentive and advertisement were associated with lower quality scores. CONCLUSION: This study demonstrated that information retrieved by the public on head injury from non-medical websites may be incomplete and inaccurate. It also identified website characteristics associated with poor content quality.

Authorship↗

PubMed2005

How to guide patients for online information: focus on chronic disease.

The purpose of this study was to evaluate the accessibility and utility of a common Internet search strategy so physicians might provide this guidance to their patients seeking health information on chronic disease. We selected three common chronic diseases: diabetes, hypertension, and osteoarthritis. We then formulated basic questions from a patient perspective about diagnosis, treatment, and prognosis. A non-medical professional attempted to answer these questions by typing the disease name into the Google search engine. Focusing on the first ten web sites on the Google list was a successful strategy for finding sites that could answer the study questions (average of 61% of the time). The average number of clicks required to answer any question was 1.6. Web sites sponsored by government agencies (89% success) and hospitals (100% success) yielded answers to the questions more often than other sites. In conclusion, despite the multitude of web sites that appear when the name of a chronic disease is entered into a search engine, the top ten results are usually adequate to provide relevant information on common clinical questions to the average patient. Physicians can guide patients to relevant information by instructing them to type the name of the disease itself into a search engine and focusing on government and hospital-sponsored Web sites.

Chronic Disease↗