Health Information Burgeoning on Internet

WASHINGTON -- In the middle of the night, the man pulled himself out of bed, unable to sleep because of lingering discomfort from his recent vasectomy. According to the handouts from his doctor, the pain should have been diminishing substantially by then. Was something wrong, or was he just being a big baby?


Up too late to call the doctor or to go to the library, he sat down instead at his computer and searched the Internet. After about a half-hour of reading online materials, he found the crucial bit of information: He needed to switch, at least temporarily, from his usual boxers to more-supportive briefs.


This suburban Washington Internet surfer is me. But I am not the only one to turn to the Internet for medical information: According to a recent study of Internet usage, more than 37 percent of America's wired households regularly seek out medical information online. And they have a wealth of information to choose from: An estimated 10,000 sites on the burgeoning World Wide Web contain consumer health information, according to the study, "Consumer Health and Medical Information on the Internet,'' published by the research group FIND/SVP.


But can the information on the Net be trusted?


An editorial in last week's edition of the Journal of the American Medical Association warned, "let the reader and viewer beware'' of online "snake oil.'' Although experts differ as to the amount of flawed information that can be found online, boosters of online medical information say savvy consumers can learn to separate the wheat from the chaff.


Meanwhile, medical sources on the Web continue to grow. Last week, the federal government brought a big new entry to this crowded field. Healthfinder (www.healthfinder.gov) is a new site on the World Wide Web that serves as an entry point for a vast collection of hundreds of other health information sites maintained by federal, state and local governments, as well as universities and not-for-profit groups.


While launching Healthfinder during a conference on health information on the web, Vice President Al Gore called the wealth of online consumer health information "a mixed blessing,'' because "finding high-quality information that is accurate, timely, relevant and unbiased is a daunting challenge to even the most experienced web surfer.''


Concerns over the quality of health-care information online have been building, as evidenced by the editorial in the Journal of the American Medical Association. "At first glance, science and snake oil may not always look all that different on the net,'' wrote William Silberg, George Lundberg and Robert Mussacchio of the American Medical Association. "Those seeking to promote informed, intelligent discussion often sit byte by byte with those whose sole purpose is to advance a political point of view or to make a fast buck.''


The authors recommended that "basic quality standards'' be developed so that those turning to the net for medical information be able to distinguish the gold from the dross.


Relying on some of the same qualities that lend credibility to printed medical information, the authors recommended that contributors to web sites be identified and their credentials be given, along with references and sources for information. They also recommended that commercial ownership be fully disclosed. While not calling for any attempt to censor sites that do not comply with such standards, the authors suggested that any site not complying should be seen by consumers as suspect.


Although the amount of erroneous, biased or hucksterish material online is unclear, it can certainly be found, said John Renner, a professor at the University of Kansas School of Medicine who founded the Consumer Health Information Research Institute. Renner investigates medical quacks and said, "It took 'em a nanosecond to find the Internet.''


While acknowledging that there are quacks hoping to profit from an online connection, Tom Ferguson of Boston's Center for Clinical Computing said the problem is sometimes overstated by those who find the Internet threatening.


Ferguson said sites like Healthfinder can be valuable to consumers, but they constitute only part of the way that the online world provides important health information. Using the Internet as a huge global library is appropriate for new searchers, he said. But increasingly people are using the Internet for reaching other people, not just information.


"If you have a chronic health concern of almost any kind,'' Ferguson said, "it's a pretty good bet that there is a community out there of experienced self-helpers who would be happy to have you join them.''


Medical professionals often do participate in many of these forums, "with the professionals learning as much as or more than the patients,'' said Ferguson, whose medical self-help web site can be found at www.healthy.net/selfcare.