Spring 2004 Edition

May 3, 2004

The World Wide Web (WWW) is perhaps the ultimate e-Health application. It has influenced commerce, communication and even our social lives. Indeed, it would be surprising if the WWW did not have a profound effect on our health. The enormous amount of freely available health information is both the biggest advantage and major problem with the WWW. The number of health-related websites is difficult to determine precisely, however a May 1, 2004 search on Google for “health” returns 204,000,000 results. Consumers responded and many are searching the WWW for health information. Searching for health information online using general purpose search engines such as Google is the third most common use of the Internet behind email and product research according to the Pew Research Center. Further, there is evidence that consumers are satisfied with their online experience and are making choices based on the information that they encounter.

Clearly, a great deal of information is available online to answer consumer’s health questions. However, many have questioned the quality and accuracy of online health information, especially in the area of complementary and alternative medicine (CAM). In a review of CAM websites we found that the majority of sites that provided CAM information were selling CAM products and were not likely to provide any scientific support (references to the biomedical literature) for their claims. Since many consumers are using CAM therapies without input from licensed clinicians, these findings are troubling.

Where does that leave the consumer of health information online? What guidance can we offer to consumers who would like to use the Internet to answer their health questions, but would like to critically evaluate what they see online? Unfortunately, we can offer very little. Hundreds of quality criteria, rating scales and other assessment tools have been proposed and widely disseminated. However, there are few (if any) empirical data to support the assertion that these tools are effective at screening out inaccurate or misleading online information. Perhaps it is not surprising, therefore, that consumers have largely ignored the quality of online health information. Instead, they focus on the information topic and content.

What is needed, therefore, is objective scientific research aimed at finding tools and techniques that can effectively screen out false or misleading information. We need to evaluate existing advice to determine if it is effective, or if new approaches must be sought. The goal should not be to restrict consumers or to attempt to regulate the Internet. Such approaches have been tried without much success. Rather, the goal should be to empower consumers to make informed choices based on empirical evidence rather than opinion and salesmanship.


Elmer Bernstam, MD, MSE
Assistant Professor
The University of Texas Health Science Center
Houston, TX

Funda Meric-Bernstam, MD
Assistant Professor
The University of Texas
M.D. Anderson Cancer Center
Houston, TX

The views expressed in this article are those of the author and do not imply endorsement by The Robert Wood Johnson Foundation.