If you have had a symptom or a health question there is a good chance you have looked for information online. During the last survey of online health information by the Pew Research Center 69 percent of Americans (80 percent of those with internet access) turned to the internet for information about their health. People use online sources to research symptoms, self-diagnose, confirm a diagnosis, investigate tests or therapies and search for alternatives not recommended by their health-care provider.
I am a big believer in the power of online medical information, which is why I am invested heavily in social media, my blog and writing for other sources, for example here in the Marin IJ. However, I feel an increased urgency to disseminate good information as we appear to be moving from the age of information to the age of misinformation. A recent study asking social media users about the quality of science-related posts found that 26 percent mostly trusted the content and 52 percent mostly distrusted the science content (the remaining 21 percent didn’t see science posts).
Sorting the good medical information from the bad online can be hard, even for a physician who has medical training, access to medical libraries, medical societies that provide guidelines and close colleagues we know to be experts in the field. There are predatory scientific journals, hidden (and not so hidden) bias, trends that get hyped, and good information is often sprinkled in with low-quality or false information. Also, let’s face it, everyone physicians included can’t resist the lure of a quick fix!
Studies tell us when the general public looks for health information online most start with a search engine, however it’s not content that drives a page above the virtual fold; it’s a mix of popularity, trends and commercial interests. Then there is comment section! Uncivil and rude comments polarize readers and can lead people to distrust the good content they have just read. Even one ad hominem attack can inflate perceived risk.
Even though many people probably think they know how to search for health information online the truth is that it is far more complicated than it appears to sort out the quality from the quacks. I recommend that everyone who searches online for health information read this crucial information from the Medical Library Association and do the short tutorial Evaluating Internet Health Information from the National Library of Medicine.
Here are some other suggestions that I have for sorting the sorcery from the science:
• Is the site selling a product related to the subject matter?
For example an article about fatigue that sells supplements for that symptom or an article about weight loss selling a diet cure? Close your browser and move along. This is exactly the same bias that we attribute to Big Pharma.
• Do they sell any supplements?
Studies tell us supplements do not prolong life, in fact they do the opposite. If your website doesn’t know that or doesn’t care then they are clearly not a source of quality, curated information.
• Quasi-scientific buzz words
Common trendy examples are “toxins,” “heavy metals,” “detoxification,” and “adrenal fatigue.” Again, close your browser. You don’t want quasi-science you want science.
• Sensationalized content
Are the outcomes extreme (everyone is cured!) or filled with scary stories of harm? This can reflect bias, lack of research or simply preying on fear. There are a lot of conspiracy theories out there and if it sounds fantastical it probably is. While there are a few exceptions, in general most therapies are not all bad or all good, there is nuance and the reality is medicine is more shades of gray than black or white. Except smoking, that’s black and white. It’s bad for you.
• Is a specific medical product or pill being promoted by a doctor?
Check the doctors on ProPublica’s Dollars for Doctors. If they have received money for promoting the product it points to bias. The information may be correct, but you always want a non biased source for confirmation.
• How old is the information?
If it is more than two years old I also recommend looking for more recent data to back up the claims or information. Medicine can change rapidly!
• Reliance on patient testimonials
This information is simply not vetted for accuracy or bias. You have no way of knowing if the person even had the correct diagnosis never mind if the therapy was truly effective. In medicine we call these case reports and they are not meant to guide therapy, rather provide insight and information about rare conditions or rare experiences. In addition, when we read about them the information has been vetted in a peer-reviewed journal. There should be good data to back up claims not “Sue from California” who said she was cured.
Sites that offer easy answers for hard problems. Obesity, fatigue, depression and cancer (just to name a few). If they had easy answers or quick fixes they would not be common.
• Develop a list of experts and sources you have come to trust
Hopefully the information that I provide here once a month and elsewhere online is part of that repertoire. When you have a question, see what that expert or health reporter has written on the subject. I do that all the time!
Dr. Jen Gunter is a Marin resident and an ob/gyn in San Francisco. Her column appears every fourth week.