Thursday, January 17, 2013

Accuracy of Medical Information on the Internet

We can just Google it!” is becoming our standard response to unanswered questions in life. Whether we are looking for the title of an irritating 80s song, a restaurant serving authentic Icelandic food or the quickest bus route to the Star Trek convention, the Internet usually offers the long-sought answers. However, when we enter key words in a search engine such as Google, we end up with thousands of websites – many of which are barely relevant to what we are looking for or are rife with inaccuracies.
Portrait of Dr. Gachet, by Vincent van Gogh, 
public domain

Identifying the websites with the most accurate and relevant information are critical skills that are necessary for navigating our way in the digital information jungle, but unfortunately, these skills are rarely taught. In most cases, inaccurate or irrelevant information on the internet merely delays us for a few minutes until we do find the answer to what we are looking for. However, when it comes to medical information, inaccurate or irrelevant information could potentially have a major detrimental impact on our well-being. Patients and their family members are increasingly using the internet as a major source of advice regarding their illnesses, treatment options, dietary advice and disease prevention. 

However, little is known about the accuracy of medical advice obtained via the internet. A study entitled “Safe Infant Sleep Recommendations on the Internet: Let’s Google It” by Dr. Rachel Moon and colleagues (published online in the Journal of Pediatrics on August 2, 2012) addresses this question by focusing on the question of sleep safety in infants. The American Academy of Pediatrics (AAP) has published guidelines for reducing the risk of sudden infant death syndrome (SIDS), suffocation or other accidental sleep-related infant deaths. Since such guidelines are written for clinical professionals, they often contain medical jargon that cannot be easily understood by concerned parents that want practical advice regarding how to ensure the sleep safety of their infants. Thus, instead of reading the AAP guidelines, most parents probably enter key phrases related to infant sleep safety into an internet search engine and may follow the advice displayed on the sites identified by the search engine.
Google Girls, by Defluiter at Wikimedia Commons

Dr. Moon and colleagues tested the accuracy of such websites by entering thirteen search phrases such as ” Infant sleep position”, ” Infant co-sleeping” or ” Pacifier sleeping” into the Google search engine, and then cross-checked the medical information offered in the search results with the AAP recommendations, which was used as the standard for medical accuracy.

Since most parents would probably read the first few pages of the Google search results, the researchers only analyzed the first 100 websites identified by each of the thirteen Google searches (total of 1300 websites). Only 43.5% of these 1300 websites contained recommendations that were in line with the AAP recommendations, while 28.1% contained inaccurate information and 28.4% of the websites were not medically relevant. The accuracy was highly dependent on the type of question asked. The search phrase “infant cigarette smoking”, for example, yielded 82% accurate results, while the search phrase “infant home monitors” resulted in only 18% accuracy.

Of note, the researchers also categorized the results by the organization or group that had generated the website. Out of the 1300 websites identified by the searches, 246 (19%) were retail product review site websites and 250 (19%) were websites associated with specific companies or interest groups. Product review retail websites were also the ones which had the lowest level of medical accuracy (8.5%). On the other hand, government websites and websites of national organizations (as identified by URL ending in .org) had the highest level of accuracy (80.9% and 72.5%, respectively).

Surprisingly, educational websites (universities or other websites with URL’s ending in .edu, ebooks, peer-reviewed articles) only had 50.2% accurate medical information, possibly due to the fact that either some of the information was not updated or that a number of the linked articles required a subscription and thus could not be accessed. The majority of the books found by the search engine either provided outdated or irrelevant information, which may have also contributed to the low accuracy rate of educational websites. Blogs and websites of individuals also had very low rates of medical accuracy (25.7% and 30.3%).

This study highlights the opportunities and pitfalls of using the internet to communicate medical information. The internet is providing an opportunity for patients and family members to obtain additional medical information that they did not receive from their physicians, as well as to address questions that may arise and do not warrant a visit to a physician. On the other hand, the study also demonstrates that the quality of medical information on the internet varies widely. Searches for certain key phrases can unwittingly lead a user to websites that promote certain products or treatments without taking the medical evidence and professional guidelines into account.

One key factor to help address this pitfall is for physicians and other healthcare professionals to actively guide patients or family members to website that are likely to have information with high levels of medical accuracy. Instead of placing the burden of discriminating between accurate and inaccurate information on patients, healthcare professionals could advise patients or parents as to what websites should be used to address medical questions that they might have.

Furthermore, government institutions, organizations and educational websites need to realize the importance of maintaining up-to-date and accessible medical information on their websites. Concerted efforts between government or educational institutions, professional organizations and healthcare professionals are necessary so that patients can maximally benefit from the information opportunities afforded by the internet.


ResearchBlogging.org Chung M, Oden RP, Joyner BL, Sims A, & Moon RY (2012). Safe infant sleep recommendations on the Internet: let's Google it. The Journal of pediatrics, 161 (6), 1080-4 PMID: 22863258

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