Prescription for success consumer health information on the web
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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.

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Prescription for success consumer health information on the web

Prescription for Success:Consumer Health Information on the Web

Bette Anton, MLS

[email protected]


This workshop is brought to you by

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

Introductions

  • Name

  • Library

  • Position

    • What brings you here?

    • Are there health-related questions that you are frequently asked?


Objectives

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


Prescription for success consumer health information on the web

  • 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?

Pre-Test


The patron s path to you

Patient

Friend/Relative

Librarian

The Patron’s Path to You

Fibrocystic

breast disease

Physician

Cystic Fibrosis


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

What the Patron Says, What the Patron Means


The health reference interview

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.


Prescription for success consumer health information on the web

  • From NLM & NIH

  • Authoritative & up-to-date information

  • Encyclopedia & dictionary

  • Drug & supplement information

  • Clinical trial information

  • Updated daily

  • No advertising


Medlineplus en espa ol

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

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

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

Other MedlinePlus Resources

  • Drug & supplement information

  • News

  • Doctor/hospital finder

  • Interactive tutorials/surgery videos

  • Local libraries


Nlm resources collaborations

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

Reliable Resources for Common Consumer Health Questions

  • Complementary & Alternative Medicine

  • Cancer resources

  • Lab Tests Online

  • Drug Digest


Complementary alternative medicine cam

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

Integrative Medicine

  • Combines mainstream medical therapies and CAM therapies for which there is some high-quality scientific evidence of safety and effectiveness.


Prescription for success consumer health information on the web

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

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

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 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

Lab Tests Online

My doctor says my cholesterol is 210. What does that mean?

http://www.labtestsonline.org/


Prescription for success consumer health information on the web

  • Why is evaluation of health websites important?

  • How is evaluation of health web sites different from evaluation on non-health websites?


Evaluation issues

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

What Do We KnowAbout 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 andappraise health information on the world wide Web? BMJ. 2002 March 9; 324 (7337): 573–577.


Five criteria for evaluation

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

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

¡¡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

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

Accuracy Example

http://www.malepregnancy.com/


Authority

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

Authority Example

http://members.tripod.com/~tourette13/


Prescription for success consumer health information on the web

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

Bias Example

http://bseinfo.org/


Currency

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

Currency Example

http://www.nytimes.com/specials/women/whome/hrt.html


Coverage

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

Coverage Example

http://www.medical-library.net/


Prescription for success consumer health information on the web

http://servers.medlib.hscbklyn.edu/ebm/2100.htm


Evaluate evaluate evaluate1

¡¡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

More Evaluation Tips

  • “May” v. “will”

  • “Proves” - one study alone infrequently proves something.

  • “Breakthroughs” rarely happen.

  • Beware of miraculous cures.


Medlineplus evaluation resources

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

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

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.


Prescription for success consumer health information on the web

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

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-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

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?

Post-Test


In summary

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

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/


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