The Quality of Medical Information on the Internet
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美国医学会眼科杂志中文版990113The Quality of Medical Information
on the Internet
A New Public Health Concern
The Internet, which was invented to facilitate the exchange of information between government scientists across the United States, has evolved into a heavily trafficked reference resource for the public. Via the World Wide Web and scores of newsgroups, the Internet now provides access to a tremendous volume of health-related information directed toward both health care professionals and laypersons. This medium, which can provide immediate access to a wealth of valuable information that might not be readily available through traditional sources, has been described as ushering in “the next transformation in the delivery of health care”.
, 百拇医药
The procurement of detailed, specific medical information in language understandable to the layperson can be a challenging task; local libraries often carry a limited collection of specialized medical textbooks or journals that might not be easily understood by persons who are unfamiliar with medical terminology or who do not have a background in the medical sciences. The same can be true of local bookstores and, in addition, medical texts are often prohibitively expensive. The Internet has expanded rapidly to address the demand for medical information on diseases and other specific conditions; this material, written in the often informal language characteristic of the medium, has the potential to empower the public by improving their understanding of health care issues and their own health and enhancing their ability to participate actively in their own care. In addition, discussion groups devoted to specific conditions and diseases can publicize local resources and provide valuable emotional support.
, http://www.100md.com
However, while immediate access to such information has been of great benefit to health care professionals and patients, there is growing concern that a substantial proportion of clinical information on the Internet might be inaccurate, erroneous, misleading, or fraudulent, and thereby pose a threat to public health. These concerns have prompted the US Food and Drug Administration to consider regulating pharmaceutical advertising and promotion on the Internet as it is regulated in traditional print and broadcast media. While it is accepted that the US Food and Drug Administration has the authority to regulate US prescription drug and medical device advertising on the Internet, an obvious limitation is that the Internet is global and, therefore, much of its content is well beyond the reach of the US Food and Drug Administration. Furthermore, in striking down the Computer Decency Act of 1996, US courts have demonstrated a reluctance to support governmental control and censorship of a medium described as “the most participatory form of mass speech yet developed.”
, http://www.100md.com
Medical information that is free from central editorial control is therefore exptempted to characterize its reliability in general terms by investigating the quality of information regarding specific topics disseminated through discussion groups or on the World Wide Web. For example, Culver et al studied a discussion group for sufferers of painful hand and arm conditions. In their review of more than 1600 consecutive messages posted throughout a 5-month period, they found that approximately 90% of the messages providing medical information were authored by persons without professional medical training, and that approximately one third of all medical information provided could best be categorized as “unconventional.” In a broader and more systematic survey of the World Wide Web, Impicciatore et al used search engines to identify parent-oriented Web sites that provided advice for the management of childhood fever. Of 41 Web sites identified at that time, only 4 adhered closely to published guidelines for home management of childhood fever, and some pages proposed potentially dangerous remedies.
, 百拇医药
It might be argued that the Internet suffers no more from error and inaccuracy than do many traditional informal sources of health care information, including acquaintances, pamphlets, and popular press articles. Nevertheless, some might attach a certain authority to electronically distributed information, especially if the originating site is adorned with official-looking seals and logos. It is also of concern that given the ambit of the Internet, the potential audience for misleading or dangerous information is enormous.
, 百拇医药
In proposing how the quality of medical information on the Internet might be elevated and assured, Silberg et al have focused on the issue of accountability; they argue that authors and publishers who stand behind their work should provide the public information by which the substance of their work might be judged. They propose that Web sites posting health-related information should clearly disclose authorship and credentials, cite references and sources for all content, and fully disclose site ownership, sponsorship, underwriting, commercial funding arrangements or support, and potential conflicts of interest. Furthermore, all postings should be dated. while such information may suggest outdatedness, ignorance, or bias to the reader, the authors themselves acknowledge that it by no means ensures the accuracy and reliability of the content. Wyatt, commenting on the study of Impicciatore et al, points out that recommendations inconsistent with current practices were advocated on pages that adhered to these proposed standards of accountability.
, http://www.100md.com
A mechanism by which consumers could be assured of the quality of health-related discussion forums and Web sites might be extremely valuable. To this end, several Internet resources have been established that review and rate health information sites. Nevertheless, even this approach is not without its detractors; it has been argued that such instruments may well restrict free expression by imposing conventional positions on controversial arguments, thus denying an enlightened perspective.
, 百拇医药
Furthermore, such instruments, if flawed, could compound the problem of public misinformation by lending credibility to sites of poor quality. Using various strategies to identify rating instruments. Jadad and Gagliardi performed an exhaustive search of the Internet. Of 47 rating instruments identified, only 14 described the criteria used to produce the ratings, and none provided information concerning construct validity. The authors therefore concluded that in general, these instruments are poorly developed and of questionable value., 百拇医药
单位：
关键词：
美国医学会眼科杂志中文版990113The Quality of Medical Information
on the Internet
A New Public Health Concern
The Internet, which was invented to facilitate the exchange of information between government scientists across the United States, has evolved into a heavily trafficked reference resource for the public. Via the World Wide Web and scores of newsgroups, the Internet now provides access to a tremendous volume of health-related information directed toward both health care professionals and laypersons. This medium, which can provide immediate access to a wealth of valuable information that might not be readily available through traditional sources, has been described as ushering in “the next transformation in the delivery of health care”.
, 百拇医药
The procurement of detailed, specific medical information in language understandable to the layperson can be a challenging task; local libraries often carry a limited collection of specialized medical textbooks or journals that might not be easily understood by persons who are unfamiliar with medical terminology or who do not have a background in the medical sciences. The same can be true of local bookstores and, in addition, medical texts are often prohibitively expensive. The Internet has expanded rapidly to address the demand for medical information on diseases and other specific conditions; this material, written in the often informal language characteristic of the medium, has the potential to empower the public by improving their understanding of health care issues and their own health and enhancing their ability to participate actively in their own care. In addition, discussion groups devoted to specific conditions and diseases can publicize local resources and provide valuable emotional support.
, http://www.100md.com
However, while immediate access to such information has been of great benefit to health care professionals and patients, there is growing concern that a substantial proportion of clinical information on the Internet might be inaccurate, erroneous, misleading, or fraudulent, and thereby pose a threat to public health. These concerns have prompted the US Food and Drug Administration to consider regulating pharmaceutical advertising and promotion on the Internet as it is regulated in traditional print and broadcast media. While it is accepted that the US Food and Drug Administration has the authority to regulate US prescription drug and medical device advertising on the Internet, an obvious limitation is that the Internet is global and, therefore, much of its content is well beyond the reach of the US Food and Drug Administration. Furthermore, in striking down the Computer Decency Act of 1996, US courts have demonstrated a reluctance to support governmental control and censorship of a medium described as “the most participatory form of mass speech yet developed.”
, http://www.100md.com
Medical information that is free from central editorial control is therefore exptempted to characterize its reliability in general terms by investigating the quality of information regarding specific topics disseminated through discussion groups or on the World Wide Web. For example, Culver et al studied a discussion group for sufferers of painful hand and arm conditions. In their review of more than 1600 consecutive messages posted throughout a 5-month period, they found that approximately 90% of the messages providing medical information were authored by persons without professional medical training, and that approximately one third of all medical information provided could best be categorized as “unconventional.” In a broader and more systematic survey of the World Wide Web, Impicciatore et al used search engines to identify parent-oriented Web sites that provided advice for the management of childhood fever. Of 41 Web sites identified at that time, only 4 adhered closely to published guidelines for home management of childhood fever, and some pages proposed potentially dangerous remedies.
, 百拇医药
It might be argued that the Internet suffers no more from error and inaccuracy than do many traditional informal sources of health care information, including acquaintances, pamphlets, and popular press articles. Nevertheless, some might attach a certain authority to electronically distributed information, especially if the originating site is adorned with official-looking seals and logos. It is also of concern that given the ambit of the Internet, the potential audience for misleading or dangerous information is enormous.
, 百拇医药
In proposing how the quality of medical information on the Internet might be elevated and assured, Silberg et al have focused on the issue of accountability; they argue that authors and publishers who stand behind their work should provide the public information by which the substance of their work might be judged. They propose that Web sites posting health-related information should clearly disclose authorship and credentials, cite references and sources for all content, and fully disclose site ownership, sponsorship, underwriting, commercial funding arrangements or support, and potential conflicts of interest. Furthermore, all postings should be dated. while such information may suggest outdatedness, ignorance, or bias to the reader, the authors themselves acknowledge that it by no means ensures the accuracy and reliability of the content. Wyatt, commenting on the study of Impicciatore et al, points out that recommendations inconsistent with current practices were advocated on pages that adhered to these proposed standards of accountability.
, http://www.100md.com
A mechanism by which consumers could be assured of the quality of health-related discussion forums and Web sites might be extremely valuable. To this end, several Internet resources have been established that review and rate health information sites. Nevertheless, even this approach is not without its detractors; it has been argued that such instruments may well restrict free expression by imposing conventional positions on controversial arguments, thus denying an enlightened perspective.
, 百拇医药
Furthermore, such instruments, if flawed, could compound the problem of public misinformation by lending credibility to sites of poor quality. Using various strategies to identify rating instruments. Jadad and Gagliardi performed an exhaustive search of the Internet. Of 47 rating instruments identified, only 14 described the criteria used to produce the ratings, and none provided information concerning construct validity. The authors therefore concluded that in general, these instruments are poorly developed and of questionable value., 百拇医药