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(Chest. 2003;124:2032-2033.)
© 2003 American College of Chest Physicians

Caught in the Web?

The Prospects of Online Health Information for Patients

Joseph A. Diaz, MD and Michael J. Stamp, AB

Brown Medical School Providence, RI

Correspondence to: Joseph A. Diaz, MD, Brown University Center for Primary Care and Prevention, 111 Brewster St, Pawtucket, RI 02860

To the Editor:

In the February 2003 issue of CHEST, Peterson and Fretz1 present the results of their study investigating patient use of the Internet for personal health information. We agree with their assertion that "an educated patient is best prepared to actively participate in his or her own care," and that the Internet offers an "unprecedented opportunity for patient self-education." However, the claim that "patients seem to have a misplaced faith in the quality of health-related information available on the Internet" is specious, at best. Certainly, there is the potential for Web sites to impart unsubstantiated health information, which might yield deleterious consequences for the unwary Internet user. But evidence suggests that there are many Web sites that provide patients with sound, evidence-based medical information that may be of undoubted benefit in the health-care decision-making process.2

A recent study3 in an internal medicine practice revealed that, utilizing the most conservative estimating methods, 27% of patients use the Internet to obtain health or medical information. This number is in concordance with previously published studies,4 although Peterson and Fretz1 obtained a result of 16%. With the proportion of patients using the Internet for health information increasing, health professionals should command a greater awareness of online health and medical resources that are available to patients. This does not mean that health professionals should exert more control over online resources. There are several organizations, including the Health on the Net Foundation, the Internet Healthcare Coalition, and Health Internet Ethics, that monitor the quality of online health information.3 Rather, it is imperative that objective evidence about the efficacy of Internet-based patient education materials be gathered by health-care researchers. A detailed analysis of this data may then be applied to ensuring patients’ access to high-caliber health and medical information online.

References

  1. Peterson, MW, Fretz, PC (2003) Patient use of the Internet for information in a lung cancer clinic. Chest 123,452-457[Abstract/Free Full Text]
  2. Pew Internet and American Life Project. The online health care revolution: how the Web helps Americans take better care of themselves. Available at: http://www.pewinternet.org/reports/toc.asp?Report = 26. Accessed October 2, 2003
  3. Diaz, JA, Griffith, RA, Ng, JJ, et al Patients’ use of the Internet for medical information. J Gen Intern Med 2002;17,180-185[CrossRef][ISI][Medline]
  4. O’Connor, JB, Johanson, JF Use of the Web for medical information by a gastroenterology clinic population. JAMA 2000;284,1962-1964[Abstract/Free Full Text]

Michael W. Peterson, MD

University of California San Francisco-Fresno Fresno, CA

Correspondence to: Michael W. Peterson, MD, VMF Professor and Chief of Medicine, University of California San Francisco-Fresno, 444 South Cedar Ave, Fresno, CA 93702; e-mail; michael.peterson{at}ucsfresno.edu

To the Editor:

Dr. Diaz and Mr. Stamp raise two issues in our recently published study (February 2003)1 on patient use of the Internet for lung cancer information. First, as they correctly point out, previous studies have demonstrated a growing use of the Internet. As we pointed out in our article, we studied our unique patient population for the following two reasons: they were an older patient population; and they lived in a largely rural state. This allowed us to compare and contrast our results with those of studies of more urban populations. Second, our patients rated the quality of information on the Internet as equal to information from their physicians. While we agree that there are many sites with high-quality information, several studies have demonstrated2 3 4 5 that the overall quality of medical information is highly variable and that patients should be careful about accepting information without questioning. Dr. Diaz and Mr. Stamp also correctly point out that several organizations have developed standards for Internet information. However, these standards cannot be effectively policed at this time.6 We maintain our position that health-care professionals need to take an interest in assuring high-quality information for their patients. We do not see this activity as "exerting more control" but rather as taking the same interest in the quality of information on the Internet as physicians do for any other resource they want their patients to use.

References

  1. Peterson, MW, Fretz, P Patient utilization of information resources in a lung cancer clinic. Chest 2003;123,452-457
  2. Croft, DR, Peterson, MW An evaluation of the quality and contents of asthma education on the World Wide Web. Chest 2002;121,1301-1307[Abstract/Free Full Text]
  3. Peterson, MW Continuing medical education on the Internet: state of the art. J Contin Educ Health Prof 2000;19,242-249
  4. McClung, HJ, Murray, RD, Heitlinger, LA The Internet as a source of current patient information. Pediatrics 1998;101,E2
  5. Impicciatore, P, Pandolfini, C, Casella, N, et al Reliability of health information for the public on the World Wide Web: systematic survey of advice on managing fever in children at home. BMJ 1997;314,1875-1879[Abstract/Free Full Text]
  6. Eysenbach, G, Diepgen, TL Labeling and filtering of medical information on the Internet. Methods Inf Med 1999;38,80-88[ISI][Medline]




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