So you’re at home today, battling a cold, and you decide to look online for ideas to help. You might find great tips like eating chicken soup or garlic or apple cider vinegar in water. Most of these websites look legit, and the writers seem honest, but how do you know?
Does it even matter?
For a common cold, it’s probably no big deal to get some ideas about how to get well fast from people writing about what worked for them, but what if you or a loved one had a more serious condition? Would you want to rely on just anyone?
The best part and the worst part about searching for health information online is that there is A LOT of information. How do you know who to trust?
Researchers report that almost half of Internet users in the US have relied on information they found online to make an important life decision. Before the Internet, people could rely on a source’s reputation or its endorsement by others. People could see if the ideas presented seemed consistent with other sources or if someone was trying to sell them something. We could go to a travel agent to book our flights or talk to a sales clerk about a product. Having these “expert mediators” made our decision-making a heck of a lot easier. The combination of tons of data plus the global nature of the worldwide Web means you need to exercise your “skills of discernment” much more frequently than before. You have to figure out which source provides the best information for your needs, and this is especially true when it comes to information about your health. You need some strategies to wade through your options.
Why? What’s the worst that could happen?
Typing a question in a Google search bar is soooooo easy, and many users forget that Google does not discern the truth or credibility of any site that pops up. Google’s algorithms simply pull those addresses that seem to contain information pertaining to the question, and often that information contradicts itself from site to site. What’s even worse is that the search results can sway people’s opinions.
National Public Radio reports that in one study performed in the Netherlands, 289 participants were asked to research online and form an opinion about the measles, mumps, and rubella vaccine. Researchers manipulated the information that showed up for the participants’ online searches, making sure that some participants only had negative information about the vaccine at the top of their search list while positive reports were prioritized for others. The study’s conclusion revealed that the participants’ opinions about the vaccine were based on what appeared at the top of their search list.
Since most of us search online for information about our symptoms before we go to see a doctor or even after to get more information about a particular treatment, this could pose a problem. Syracuse University law professor Kevin Noble Maillard compares medical websites to “Magic 8 Balls,” and in his own quest to self-diagnose using an app, he found out that some information was biased, unreliable, fear-driven, and most importantly, not individualized. He says medical websites like WebMD and the Mayo Clinic led him to make an appointment with a medical doctor because “every article usually ends with a tagline of ‘consult your doctor.’”
Maillard makes the point that “self-diagnosis may
soothe, agitate, or confirm, but it doesn’t treat.”
Sometimes online health information can even be life-threatening. Patients may avoid using helpful treatments because of scary information they read online. Cardiologist Haider Warraich tells about a female patient who was having a heart attack yet didn’t fit the typical profile. It turns out she had never filled a prescription for a statin medication to lower her high cholesterol. Why? She had read about supposed side effects of statins online. Dr. Warraich points out that based on a blind research trial using statins, sometimes patients experience side effects simply because they are expecting them (the “nocebo effect”).
Somebody should regulate these health websites, right?
The US Department of Health and Human Services Office of Disease Prevention and Health Promotion (ODPHP) has created two objectives to promote website quality as part of their Health People 2020 initiative: reliability in information and in usability. Reliability in information means accuracy in the content as well as transparency in the ownership and purpose of the site. Website usability includes how easy it is to navigate the site and how users interact with content and its organization.
Objectives like these, while a step in the right direction, lack real consequences for those sites which don’t comply. Some have suggested that search engines and social media platforms like Facebook should be held responsible for fake medical content they promote or host, and while it may seem more comfortable to let the government handle this issue, it doesn’t help you or me when we need health information right now for ourselves or our loved ones.
What can I do? I’m no doctor.
Me neither. Open communication among patient, caregiver, doctor, and product provider (i.e., treatment or pharma provider) is essential. Educating ourselves is a good first step in this communication process, and often that means checking out health information online. We can take responsibility for figuring out if the information we’ve found is from a credible website by seeing if the site we’re reading meets six benchmarks:
- Accuracy: The information seems to be error-free, following basic grammar and spelling rules. It can be corroborated off-line with well-respected sources and appears reliable.
- Authority: The author’s credentials should be available, and you should be able to contact him/her. It also should be clear who the site publisher or sponsor is. You’ll find the website publisher name by scrolling down to the bottom of the web page (or homepage) and looking for the copyright sign (©).
Sometimes you won’t be able to reach the bottom of the page because the content goes on and on. In this case, check out the “About” tab available on most websites.
- Coverage: The site should provide links to sources used as references, and these links should go to well-respected sources outside the site itself. No fees or special browser or software should be required.
- Currency: The article should provide the date published or the date it was updated or revised. There should be no dead links or outdated content.
- Objectivity: The article and site should have a minimum of bias, and no attempts should be made to sell a product or persuade you to buy something. The pharmaceutical company Eli Lilly sponsored a quiz in 2010 to self-diagnose for depression on the website WebMD. As it turned out, anybody who took the quiz, regardless of their answers, received the message: “You may be at risk for major depression.” Eli Lilly manufactures one of the most commonly prescribed drugs for depression, Cymbalta, and this illustrates the problem of bias.
- Purpose: Notice what audience the article or site is geared for by paying attention to the language or tone of the content. Also, make note of how easily you can navigate a site and how quickly you can locate the information you’re looking for. The site should give context and provide the next step in the journey or process of testing or treatment.
Sounds overwhelming. Can you walk me through?
Sure. We’ll take a look at the top three websites that show up on the Google search “Home Remedies for Diabetes.”
1) Healthline.com – “15 Easy Ways to Lower Blood Sugar Levels Naturally” by Arlene Semeco.
- Accuracy: The article provides information that seems reliable and comparable to other websites. Good grammar and spelling are used.
- Authority: Arlene Semeco has the credentials of MS, RD, which means she has a master’s degree and is a registered dietician. There is a link with her name, and it sends me to a page called “Our Team” which shows brief bios for the management team and writers. I don’t see Arlene Semeco’s name or picture on the list. Since the article is from 2016, perhaps she doesn’t write for Healthline.com any more. However, the “Our Team” page provides mailing addresses and phone numbers. The publisher is Healthline Media.
- Coverage: The article provides links that go to scholarly, research articles on a government website. No special fees, browser, or software is required.
- Currency: Article provides the date published (May 3, 2016).
- Objectivity: The site discloses that they may receive some compensation if readers click on an advertiser’s link and/or purchase a product. The site also contains a certification called HONcode standard for trustworthy health information. This is a non-governmental organization that promotes ethics in online health information, and certification by HONcode requires review by a committee that includes medical professionals.
- Purpose: The article and website seem geared for providing general information. The site also encourages readers to check with their physician before making dietary or lifestyle changes.
VERDICT: The Healthline.com article seems OK though it may be a little old (written in 2016).
2) Verywellhealth.com – “8 Natural Remedies for Type 2 Diabetes” by Cathy Wong, reviewed by Richard N. Fogoros, MD.
- Accuracy: The article provides information that seems reliable and comparable to other websites, and it uses typical grammar and spelling.
- Authority: Author credentials are provided. Cathy Wong is certified as a nutrition specialist and journalist by the American College of Nutrition. Her article has been reviewed by a medical doctor (Richard N. Fogoros, MD) who is a retired cardiologist. While Dr. Fogoros has written extensively, his profile doesn’t show that he has written about Type 2 diabetes before.
- Coverage: The article provides 11 links as references throughout, but all the links go to other articles within the Verywellhealth website. All of the links but one were written by the same author, Cathy Wong. No special fees or software required.
- Currency: The article provides the date updated (Sept. 30, 2018) but not the original date published.
- Objectivity: The article does not attempt to sell a product, and the site contains the HONcode standard for trustworthy health information.
- Purpose: The article and website seem geared for providing general information.
VERDICT: The Verywellhealth article seems to present information that can be corroborated by other sites, and it does have the HONcode certification; however, its lack of references to research-based articles makes it less desirable as a good source for health information.
3) Doctor.NDTV.com – “World Diabetes Day 2018: 12 Tried and Tested Home Remedies for Diabetes” by DoctorNDTV.
- Accuracy: The article provides information that is somewhat comparable to other sites, but some wording is questionable and unfamiliar. For example, the article says, “But home remedies are the best remedy for curing diabetes. These remedies includes eating karela, dalchini, methi, amla, jamun, herbs, spices, etc.”
- Authority: No author name is provided, and when we look at who the publisher of the website is (located in the “About Us” tab at the bottom of the FAQ webpage), we find it is New Delhi TV located in India.
- Coverage: The article contains no links or references for the information provided.
- Currency: The article provides the date published (Nov. 13, 2018).
- Objectivity: The article does not appear to promote or sell a product though there are lots of unrelated ads.
- Purpose: The website is not devoted to health but includes other topics like entertainment and business. The article and website assert their credibility but don’t provide any sources or proof to back it up:
“DoctorNDTV is the one stop site for all your health needs providing the most credible health information, health news and tips with expert advice on healthy living, diet plans, informative videos etc. You can get the most relevant and accurate info you need about health problems like diabetes, cancer, pregnancy, HIV and AIDS, weight loss and many other lifestyle diseases. We have a panel of over 350 experts who help us develop content by giving their valuable inputs and bringing to us the latest in the world of healthcare.”
VERDICT: Despite appearing in the #3 position in the Google search, the article at DoctorNDTV does not seem to be a credible source for healthcare information.
Researching health information online offers unlimited information from lots of sources, both good and bad. By being aware that Google is only a search engine, unable to discern the truth or accuracy of the information provided, we can take control of what information we trust by applying the six benchmarks: accuracy, authority, coverage, currency, objectivity, and purpose. We can take the information we find online, use it to ask questions of our physicians, and make better-informed choices in our healthcare. Doctorpedia is here to help you gain the information you need to know for your next step in the journey toward health.
- The commitment to reliable health and medical information on the internet (2017). HONcode. Retrieved from
- Devine, T., Broderick, J., Harris, L.M., Wu, H., Hillfiker, S.W. (2016). Making quality health websites a national public health priority: Toward quality standards. Journal of Medical Internet Research, 18, 8, e211. doi: 10.2196/jmir.5999
- DoctorNDTV (2018). World diabetes day 2018: 12 tried and tested home remedies for diabetes. DoctorNDTV. Retrieved from
- Maillard, K.N. (2016). With medical websites, a cough is no longer just a cough. The New York Times. Retrieved from
- Margolis, J. (2017). Seeking online medical advice? Google’s top results aren’t always on target. National Public Radio. Retrieved from
- Metzger, M. J., & Flanagin, A. J. (2013). Credibility and trust of information in online environments: The use of cognitive heuristics. Journal of Pragmatics, 59, 210-220. Retrieved from
- Semeco, A. (2016). 15 easy ways to lower blood sugar levels naturally. Healthline. Retrieved from
- Teicher, J. (2017). Should pharmaceutical companies be allowed to do content marketing? The Content Strategist. Retrieved from
- Warraich, H. (2018). Dr. Google is a liar. The New York Times. Retrieved from
- Wong, C. (2018). 8 natural remedies for type 2 diabetes. VerywellHealth. Retrieved from
Nan Kuhlman is an author, freelance writer, and part-time university professor based in Los Angeles, CA. She currently works full-time as a technical writer in Los Angeles and part-time as an online adjunct writing instructor. She has written for scholarly publications like the University of California, Davis Writing on the Edge and Chapman University’s Anastamos Interdisciplinary Journal, among others.