Transcript ppt - Infopeople

Prescription for Success:
Consumer Health Information
on the Web
Bette Anton, MLS
[email protected]
This Workshop Is Brought to You By
National Network of Libraries of
Medicine, Pacific Southwest Region,
UCLA Louise M. Darling Biomedical
Library.
Funded by the National Library of
Medicine
Infopeople Project
Introductions
Name
Library
Position
What brings you here?
 Are there health-related questions that you are
frequently asked?

Objectives
Use MedlinePlus to aid health seekers to:
find reliable disease-specific information
 find reliable drug & supplement information
 find hospitals and doctors
 find the latest health news

Be able to identify and use:
NLM and other government websites to find
answers to commonly asked health questions
 Websites specifically designed for California
and multi-cultural health seekers

Develop strategies for finding and
evaluating health information on the
Internet
Pre-Test
MedlinePlus can help you find a local consumer
health library. T F
Reference librarians can provide advice about
health information. T F
Name three criteria for evaluating a health
website.
What is the name of the largest biomedical library
in the world?
The Patron’s Path to You
Fibrocystic
breast disease
Physician
Patient
Friend/Relative
Cystic Fibrosis
Librarian
What the Patron Says,
What the Patron Means
Sick lick vomiting
Rose acre
Fireballs in the
Eucharist
Sweet smiling Jesus
Cyclic vomiting
Rosacea
Fibroids in the
uterus
Spinal meningitis
The Health Reference Interview
Determine who the information is for.
Use dictionary, anatomy book or medical
encyclopedia first.
Have patron contact health care provider if
sufficient information is unavailable.
Never provide interpretation of the
information, or advice. Always suggest that
patron contact her/his health care provider.
From NLM & NIH
Authoritative & up-to-date information
Encyclopedia & dictionary
Drug & supplement information
Clinical trial information
Updated daily
No advertising
MedlinePlus en Español
MedlinePlus is available in Spanish by
clicking on the “español” link.
All materials responsive to language,
dietary, and cultural needs of Hispanic
population.
http://medlineplus.gov/spanish/
MedlinePlus Resources
Encyclopedia includes 4,000+ entries on
diseases, tests, symptoms, injuries and
surgeries, and an extensive library of
photographs and illustrations.
Medical Dictionary
Health Topics
http://medlineplus.gov/
Bookmarks
Go to: bookmarks.infopeople.org
Look for the class bookmark file.
[prescription_success_bk.html]
Click on it so it shows on the screen.
With the class bookmark file showing in Internet
Explorer, click the Favorites menu, choose Add to
Favorites…
Notice the name in the Name: box so that you can use
the Favorites list to get back to the class bookmarks
for the rest of the day.
Other MedlinePlus Resources
Drug & supplement information
News
Doctor/hospital finder
Interactive tutorials/surgery videos
Local libraries
NLM Resources
& Collaborations
NIH Senior Health
clinicaltrials.gov
DIRLINE
Genetics Home Reference
American Indian Health
Household Products Database
Tox Town
Reliable Resources for Common
Consumer Health Questions
Complementary & Alternative
Medicine
Cancer resources
Lab Tests Online
Drug Digest
Complementary &
Alternative Medicine (CAM)
“Diverse medical & health care systems,
practices, and products …not presently
considered to be part of conventional
medicine.”
Source: http://nccam.nih.gov/health/whatiscam/
Less evidence of efficacy of treatments and
safety.
36% of adults over age 18 use some form of
alternative medicine
Source: CDC 2002 Nat’l Health Interview Survey
Integrative Medicine
Combines mainstream medical therapies
and CAM therapies for which there is some
high-quality scientific evidence of safety
and effectiveness.
National Center for
Complementary & Alternative
Medicine
http://nccam.nih.gov
My daughter, who is on Zoloft, is taking St. John’s Wort for
depression. Does it really work?
Reliable Cancer Information
National Cancer Institute
http://www.cancer.gov/
American Cancer Society
http://www.cancer.org
University of Pennsylvania’s Oncolink
http://www.oncolink.org
My mother was diagnosed with cervical cancer. I think they called it
stage IIA. What can you tell me about it? Is she going to have chemo
or radiation?”
Drug Web Sites
Many drug sites are commercial ones.
Many are simply advertising for
pharmaceutical companies or particular
drugs.
Direct-to-consumer advertising of
prescription drugs can be misleading.
Drug Digest
Drug Library
Interactions
Comparisons
Conditions & Treatments
Interactive Tools
Are there interactions between St. John’s Wort and Zoloft?
http://www.drugdigest.org/
Lab Tests Online
My doctor says my cholesterol is 210. What does that mean?
http://www.labtestsonline.org/
Why is evaluation of health websites
important?
How is evaluation of health web sites
different from evaluation on non-health
websites?
Evaluation Issues
Increasing number of :
 patients accessing information on the
Internet
 health-related websites
Patients believe that the web is a
reliable source of information
What Do We Know
About Consumer Behavior?
Consumers use search engines rather than
medical portals or sites of medical societies or
libraries.
When assessing the credibility, they claim to
primarily look for the source, professional
design, scientific or official touch, language, and
ease of use.
Under observation, none checked “about us”
sections, disclaimers, or disclosure statements.
Source: Eysenbach, G, Köhler, C. How do consumers
search for and appraise health information on the world
wide Web? BMJ. 2002 March 9; 324 (7337): 573–577.
Five Criteria for Evaluation
Accuracy
Authority
Bias
Currency
Coverage
Each of these alone is
meaningless, but together they
create solid guidelines for
evaluation.
Read URL Carefully
Is it someone’s personal page?
~ or %
 geocities or aol.com

What type of domain does it come from?

.gov or .edu or .org
Who is the “publisher”?

http://publisher/
¡¡Evaluate, Evaluate, Evaluate!!
Scan the perimeter of the page and think
about these questions:
 Why did the person create the page?
 What’s in it for them?
 Are they trying to sell something?
Contact information
About us
Now apply the five criteria
Accuracy
Is the information accurate? Remember:
Anyone can publish on the web
 Many web pages are not reviewed or verified
by editors or peers
 Web standards to ensure accuracy do not exist

Accuracy Example
http://www.malepregnancy.com/
Authority
Is the author an authority on the subject?
Remember:
It is often difficult to determine the authorship
of web pages
 If a name is listed, the author’s qualifications
are frequently absent
 Check if the web page has the backing of a
well-established organization, institution, or
agency

Authority Example
http://members.tripod.com/~tourette13/
Bias
Does the author bring any biases in posting
the information? Remember:
Web pages often are “soapboxes”
 Check that the author’s goals are clearly stated
 Watch out for the emotional “kick”…
photographs, exclamation points, huge fonts

Bias Example
http://bseinfo.org/
Currency
Is the information current and timely?
Remember:
Dates are not always included
 If dates are included it may not be clear if it is:

Date created
 Date revised
 Date page was placed on Web

Currency Example
http://www.nytimes.com/specials/women/whome/hrt.html
Coverage
Many health sites are not comprehensive.
The information may be accurate but
important information may be left out.
Remember:
How does the information compare with other
sources on the same topic?
 Is a better source available?
 Does the site have a disclaimer?

Coverage Example
http://www.medical-library.net/
http://servers.medlib.hscbklyn.edu/ebm/2100.htm
¡¡Evaluate, Evaluate, Evaluate!!
“Contributes to”, “is linked to”, “associated
with” is not the same as “causes”
“Doubles the risk” is meaningful depending
upon what risk was in the first place
“Significant” is not the same as
“statistically significant”
More Evaluation Tips
“May” v. “will”
“Proves” - one study alone infrequently
proves something.
“Breakthroughs” rarely happen.
Beware of miraculous cures.
MedlinePlus Evaluation Resources
Evaluating health Internet information: a Tutorial
http://www.nlm.nih.gov/medlineplus/webeval/webeval.html
Health fraud resource
http://www.nlm.nih.gov/medlineplus/healthfraud.html
Health Literacy
Health literacy is the ability
to read, understand, and act
on health care information.
Source: Center for Healthcare Strategies, http://www.chcs.org/usr_doc/FS1.pdf
Who Has
Health Literacy Problems?
People of all backgrounds, especially those
with chronic health problems
Most adults in U.S. read at 6th grade level,
45% below 6th grade level.
Older people, immigrants & those with low
incomes are disproportionately more likely
to have trouble reading & understanding
health-related information.
According to the latest U.S. census data, 41%
of Californians over the age of 5 speak a
language other than English at home.
Multilingual Resources
What language group(s) does your library
serve?
The NN/LM provides links to many
multilingual resources
http://nnlm.gov/train/chi/multi.html
California-Specific Web Sites
California Department of Health Services
California Healthcare Foundation
What Patients Think of California Hospitals
 California Nursing Home Search
 Online Enrollment for Public Health Insurance

NN/LM/PSR
http://nnlm.gov/psr/about/region/california.html
Action Plan: Next Steps
Post-Test
MedlinePlus can help you find a local
consumer health library. T F
Reference librarians can provide advice
about health information. T F
Name three criteria for evaluating a health
Web site.
What is the name of the largest biomedical
library in the world?
In Summary
The National Library of Medicine
provides many important and reliable
consumer health resources.
Evaluation of unknown sites is essential.
Health seekers frequently have difficulty finding,
understanding and using health information.
NEVER provide medical advice. Send patrons to
their health care providers for advice and
interpretation of health information.
Wrap-Up
How to reach NNLM/PSR:
http://nnlm.gov/psr/ or 1.800.338.7657
Funding opportunities:
http://nnlm.gov/psr/funding/
Other classes:
http://nnlm.gov/psr/training/
Member Services
http://nnlm.gov/psr/members/