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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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Presentation Transcript
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
slide5
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.
slide10
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.
slide19
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/

slide24
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/

slide34
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/

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.
slide46
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
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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